title: Radiation therapy combined with (or without) cisplatin-based chemotherapy for patients with nasopharyngeal cancer: 15-years experience of a single institution in Korea.
abstract: OBJECTIVE
  This retrospective study was carried out to evaluate the efficacy and toxicity of radiation therapy (RT) with/without cisplatin-based chemotherapy in nasopharyngeal cancer (NPC).
  
  
  METHODS
  One hundred forty six patients with NPC received curative RT and/or cisplatin-based chemotherapy. Thirty-nine patients were treated with induction chemotherapy (IC), including cisplatin and 5-fluorouracil followed by RT. Another 63 patients were treated with concurrent chemoradiotherapy (CCRT) using cisplatin, and 22 patients were treated with IC followed by CCRT. The remaining 22 patients were treated with RT alone.
  
  
  RESULTS
  One hundred four (80.0%) patients achieved complete response (CR), and 23 (17.7%) patients achieved partial response (PR). The patterns of failure were: locoregional recurrences in 21.2% and distant metastases in 17.1%. Five-year overall survival (OS) and progression free survival (PFS) were 50.7% and 45.0%, respectively. Multivariate Cox stepwise regression analysis revealed CR to chemoradiotherapy to be a powerful prognostic factor for OS. CR to chemoradiotherapy and completion of radiation according to the time schedule were favorable prognostic factors for PFS. A comparison of each treatment group (IC --> RT vs. CCRT vs. IC --> CCRT vs. RT alone) revealed no significant differences in the OS or PFS. However, subgroup analysis showed significant differences in both OS and DFS in favor of the combined chemoradiotherapy group compared with RT alone, for stage IV and T3-4 tumors. Grade 3-4 toxicities were more common in the combined chemoradiotherapy arm, particularly in the CCRT group.
  
  
  CONCLUSIONS
  This study was limited in that it was a retrospective study, much time was required to collect patients, and there were imbalances in the number of patients in each treatment group. Combined chemoradiotherapy remarkably prolonged the OS and PFS in subgroup patients with stage IV or T3-4 NPC.
authors.affiliation: Department of Radiation Oncology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yeon-Sil
authors.initials: YS
authors.lastname: Kim
authors.forename: Bum-Soo
authors.initials: BS
authors.lastname: Kim
authors.forename: So-Lyoung
authors.initials: SL
authors.lastname: Jung
authors.forename: Yeon-Soo
authors.initials: YS
authors.lastname: Lee
authors.forename: Min-Sik
authors.initials: MS
authors.lastname: Kim
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: Sun
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Yoo
authors.forename: Seong-Kwon
authors.initials: SK
authors.lastname: Mun
authors.forename: Sei-Chul
authors.initials: SC
authors.lastname: Yoon
authors.forename: Su-Mi
authors.initials: SM
authors.lastname: Chung
authors.forename: Hoon-Kyo
authors.initials: HK
authors.lastname: Kim
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Jo
authors.forename: Jin-Hyoung
authors.initials: JH
authors.lastname: Kang
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