Concurrent chemoradiation followed by adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma in Korea.
OBJECTIVE
Concomitant approach using cisplatin and 5-fluorouracil (5-FU) has shown an excellent local control rate and significantly reduced distant metastasis in patients with locally advanced nasopharyngeal carcinoma (NPC). However, optimal schedule and dosing of chemotherapy still need to be developed to reduce distant metastasis. This retrospective study was conducted to evaluate the efficacy, toxicity, and tolerability of a concurrent chemoradiation therapy (CCRT) regimen using cisplatin and 5-FU followed by adjuvant chemotherapy (AC) in patients with locoregionally advanced NPC.


METHODS
Forty-three NPC patients who had AJCC stage T3/T4 or N2/N3 and M0 disease were evaluated. The chemotherapy during CCRT consisted of cisplatin (75 mg/m(2) on day 1) plus 5-FU (750 mg/m(2)/day on day 1-5), delivered every 4 weeks for two cycles. Three cycles of AC were given with cisplatin (75 mg/m(2)), epirubicin (37.5 mg/m(2)) on day 1, and bleomycin (7.5 mg/m(2) bolus iv. on day 1 followed by 9 mg/m(2) on day 1-5 by continuous infusion) every 3 weeks.


RESULTS
The overall response rate after CCRT was 95% (22 CRs and 19 PRs in 43) and 100% (16 CRs and 8 PRs in 24) after AC. Grade 3/4 neutropenia, mucositis, and weight loss were observed during CCRT phase in 18, 44, and 26% of patients, respectively. AC caused grade 3/4 neutropenia and emesis in 12.5 and 20.8% of patients, respectively.


CONCLUSIONS
CCRT regimen using cisplatin and 5-FU followed by three cycles of BEC chemotherapy was effective in locally advanced NPC patients, with acceptable and reversible acute toxicities.
Park
Kyong Hwa
KH
Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, 126-1 Anam-dong 5 ga, Seongbuk-gu, Seoul, Korea.
Kim
Jeong Sun
JS
Park
Yong
Y
Seo
Hee Yeon
HY
Park
Young Je
YJ
Choi
In Keun
IK
Oh
Sang Chul
SC
Seo
Jae Hong
JH
Kim
Chul Yong
CY
Jung
Kwang Yoon
KY
Shin
Sang Won
SW
Kim
Yeul Hong
YH
Kim
Jun Suk
JS
Lee
Nam Joon
NJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000009:adverse effects; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D009305:Nasopharynx / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D010349:Patient Compliance; D056910:Republic of Korea; D016019:Survival Analysis; D055815:Young Adult
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D001761:Bleomycin; D015251:Epirubicin; D002945:Cisplatin