Induction-concurrent chemoradiotherapy versus induction chemotherapy and radiotherapy for locoregionally advanced nasopharyngeal carcinoma.
OBJECTIVE
Induction chemotherapy and radiotherapy or concurrent chemoradiotherapy are the most two effective treatments for patients with locoregionally advanced nasopharyngeal carcinoma (NPC). This study was to compare the efficacy of induction-concurrent chemoradiotherapy versus induction chemotherapy and radiotherapy for patients with locoregionally advanced NPC.


METHODS
From August 2002 to April 2005, 408 patients were randomly divided into the induction-concurrent chemoradiotherapy (IC/CCRT) group and the induction chemotherapy and radiotherapy (IC/RT) group. Patients in both groups received the same induction chemotherapy, including two cycles of floxuridine (FuDR) plus carboplatin (FuDR750 mg/m2, d1-5; carboplatin AUC=6). All the patients underwent radiotherapy one week after completing the induction chemotherapy. The patients in the IC/CCRT group also received carboplatin (AUC=6) on day 7, 28, and 49 during radiotherapy. Eight patients did not meet the inclusion criteria and were excluded. The remaining 400 cases were analyzed.


RESULTS
Grade III/IV toxicity was found in 28.4% of the patients in the IC/CCRT group and 13.1% in the IC/RT group (P < 0.001). After a median follow up time of 3.9 years, the three-year overall survival was 75.9% and 83.4% (P = 0.12) in the IC/CCRT and IC/RT groups, respectively. No significant differences in the failure-free survival rate, the locoregional control rate, and the distant control rate were found between the two groups.


CONCLUSIONS
The IC/CCRT program does not improve the overall survival rate in patients with locoregionally advanced NPC compared with the IC/RT program.
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P.R. China.
Pei-Yu
PY
Huang
Hai-Qiang
HQ
Mai
Dong-Hua
DH
Luo
Fang
F
Qiu
Ning-Wei
NW
Li
Yan-Qun
YQ
Xiang
Qiu-Yan
QY
Chen
Li
L
Zhang
Rui
R
Sun
Ka-Jia
KJ
Cao
Ling
L
Guo
Man-Quan
MQ
Deng
Hao-Yuan
HY
Mo
Xiang
X
Guo
Feng
F
Zhang
Su-Mei
SM
Cao
Min-Yuan
MY
Chen
Ying
Y
Guo
Yu-Ying
YY
Fan
Wen
W
Hu
Yi-Jun
YJ
Hua
Guo-Feng
GF
Xie
Ming-Huang
MH
Hong
D000328:Adult; D000740:Anemia / Q000139:chemically induced / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005467:Floxuridine / Q000008:administration & dosage; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced / Q000209:etiology; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D012074:Remission Induction; D015996:Survival Rate
D005467:Floxuridine; D016190:Carboplatin