title: Treatment outcome of cisplatin-based concurrent chemoradiotherapy in the patients with locally advanced nasopharyngeal cancer.
abstract: OBJECTIVE
  The standard treatment of locally advanced nasopharyngeal cancer is a concurrent chemoradiotherapy (CCRT), and cisplatin has been used as the most popular chemotherapeutic agent. But many different doses and schedules for cisplatin administration such as daily, weekly and 3 week cycles have been proposed. We compared and analyzed the tumor response, the overall survival, the toxicity and the chemotherapy dose intensity in the patients with locally advanced nasopharyngeal cancer who were treated with CCRT.
  
  
  METHODS
  We performed a retrospective study on 55 patients with locally advanced nasopharyngeal cancer, and they were treated with CCRT as a front-line treatment from Jan 1996 to Jun 2007 at Kangnam Saint Mary's Hospital.
  
  
  RESULTS
  The patients had a median age of 53 years (range: 19 approximately 75 years). Of the total 55 patients, a 3-week cycle of 100mg cisplatin was administered in 31 patients and 30 mg weekly cisplatin was administered in 24 patients combined with radiotherapy. Twenty one patients had a complete response and four patients had a partial response for a response rate of 71.4% (95% CI: 59.5 approximately 83.3) after CCRT and followed by adjuvant chemotherapy. The complete response rates for the 30 mg and 100 mg cisplatin groups were 72.7% (95% CI: 54.9 approximately 90.5) and 54.2% (95% CI: 36.7 approximately 71.7), respectively (p=0.23). The duration of CCRT in the 100mg cisplatin group was significantly longer than that of the 30mg cisplatin group (11.1+/-2.9 weeks vs. 9.0+/-1.2 weeks, p=0.003). The major deviation group, which was defined as prolongation of the radiotherapy duration for more than 2 weeks, had a significantly lower objective response rate than did the non-deviation group (56.3% vs 84.2%, respectively, p=0.002). The major severe toxicities were leucopenia (49.1%), pharyngoesophagitis (49.1%), anorexia (43.6%), nausea (41.8%) and vomiting (40%).
  
  
  CONCLUSIONS
  Weekly 30mg cisplatin-based CCRT is a practical, feasible cisplatin schedule for the patients with locally advanced nasopharyngeal cancer in regard to decreasing the interruption of radiation treatment and decreasing the treatment-related acute toxicities.
authors.affiliation: Head & Neck Cancer Interdisciplinary Team, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Kim
authors.forename: Yoon Ho
authors.initials: YH
authors.lastname: Ko
authors.forename: Myung Ah
authors.initials: MA
authors.lastname: Lee
authors.forename: Bum-soo
authors.initials: BS
authors.lastname: Kim
authors.forename: So Ryoung
authors.initials: SR
authors.lastname: Chung
authors.forename: Ie Ryung
authors.initials: IeR
authors.lastname: Yoo
authors.forename: Chan-Kwon
authors.initials: CK
authors.lastname: Jung
authors.forename: Yeon-Sil
authors.initials: YS
authors.lastname: Kim
authors.forename: Min Sik
authors.initials: MS
authors.lastname: Kim
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: Sun
authors.forename: Young Seon
authors.initials: YS
authors.lastname: Hong
authors.forename: Kyung Shik
authors.initials: KS
authors.lastname: Lee
authors.forename: Jin-Hyoung
authors.initials: JH
authors.lastname: Kang
references.citation: Cancer. 1998 Aug 1;83(3):582-8
references.pmid: 9690553
references.citation: Jpn J Clin Oncol. 2000 May;30(5):230-4
references.pmid: 10857501
references.citation: Eur J Cancer. 2007 Jun;43(9):1399-406
references.pmid: 17467265
references.citation: J Clin Oncol. 1990 May;8(5):911-34
references.pmid: 2185342
references.citation: J Clin Oncol. 2004 Jul 1;22(13):2643-53
references.pmid: 15226332
references.citation: J Clin Oncol. 2003 Feb 15;21(4):631-7
references.pmid: 12586799
references.citation: Int J Radiat Oncol Biol Phys. 1997 Oct 1;39(3):703-10
references.pmid: 9336153
references.citation: J Clin Oncol. 2005 May 20;23(15):3568-76
references.pmid: 15809453
references.citation: Lancet. 2005 Jun 11-17;365(9476):2041-54
references.pmid: 15950718
references.citation: Int J Radiat Oncol Biol Phys. 2004 Nov 15;60(4):1127-36
references.pmid: 15519784
references.citation: J Clin Oncol. 2005 Sep 20;23(27):6730-8
references.pmid: 16170180
references.citation: Int J Radiat Oncol Biol Phys. 2004 May 1;59(1):11-20
references.pmid: 15093894
references.citation: Jpn J Clin Oncol. 2003 Oct;33(10):497-500
references.pmid: 14623916
references.citation: Cancer Control. 2002 Sep-Oct;9(5):387-99
references.pmid: 12410178
references.citation: Cancer. 1988 Mar 15;61(6):1117-24
references.pmid: 3342372
references.citation: Cochrane Database Syst Rev. 2006 Oct 18;(4):CD004329
references.pmid: 17054200
references.citation: Curr Opin Oncol. 2005 May;17(3):225-30
references.pmid: 15818165
references.citation: Mol Cancer. 2007 Jan 02;6:1
references.pmid: 17199893
references.citation: J Clin Oncol. 1998 Apr;16(4):1310-7
references.pmid: 9552031
references.citation: Ann Oncol. 2002 Jul;13(7):1007-15
references.pmid: 12176778
references.citation: Int J Radiat Oncol Biol Phys. 2000 Dec 1;48(5):1323-30
references.pmid: 11121629
references.citation: Am J Otolaryngol. 1995 Mar-Apr;16(2):103-8
references.pmid: 7540805