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.
Huang
Pei-Yu
PY
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P.R. China.
Mai
Hai-Qiang
HQ
Luo
Dong-Hua
DH
Qiu
Fang
F
Li
Ning-Wei
NW
Xiang
Yan-Qun
YQ
Chen
Qiu-Yan
QY
Zhang
Li
L
Sun
Rui
R
Cao
Ka-Jia
KJ
Guo
Ling
L
Deng
Man-Quan
MQ
Mo
Hao-Yuan
HY
Guo
Xiang
X
Zhang
Feng
F
Cao
Su-Mei
SM
Chen
Min-Yuan
MY
Guo
Ying
Y
Fan
Yu-Ying
YY
Hu
Wen
W
Hua
Yi-Jun
YJ
Xie
Guo-Feng
GF
Hong
Ming-Huang
MH
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