Feasibility and efficacy study of weekly cisplatin with concurrent intensity-modulated radiation therapy for nasopharyngeal carcinoma: preliminary results.
The aim of this study was to assess the feasibility and efficacy of a weekly cisplatin 40 mg/m(2) regimen in patients with nasopharyngeal carcinoma treated concurrently with definitive intensity-modulated radiation therapy (IMRT). The primary endpoints were treatment compliance and acute toxicities. Twenty-two patients with newly diagnosed NPC were recruited in this phase II trial. All patients received definitive IMRT concurrently with weekly cisplatin 40 mg/m(2) for six cycles. The treatment technique was split-field IMRT (SF-IMRT) before August 2009 and whole-field IMRT (WF-IMRT) thereafter. The median follow-up time was 15.1 months (range, 1.5-30 months). No patients experienced regional recurrence or distant metastasis. One patient developed local recurrence. One patient died of non-malignant disease. For all patients, the 1-year overall survival, local recurrence-free survival, regional recurrence-free survival, and distant metastasis-free survival were 95.5%, 95.5%, 100%, and 100%, respectively. All patients received the full dose of RT. Twenty-one patients (95.5%) completed all six cycles of chemotherapy (CHT). Three patients experienced treatment delay. Of them, one had CHT delay, and the other two had IMRT delay. No treatment-related death was found. Acute toxicities were generally mild or moderate. Grade 3 and 4 toxicities accounted for less than 10% of overall occurrence in each corresponding category except for a relatively higher rate in stomatitis (Grade 3, 27%). Renal function impairment was not found. Weekly cisplatin with concurrent IMRT appears to be feasible and effective in treating NPC patients and these findings warrant further investigation.
Lu
Heming
H
Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China. luhming3632@163.com
Chen
Jiaxin
J
Huang
Baoqin
B
Cheng
Jinjian
J
Peng
Luxing
L
Hao
Yanrong
Y
Liao
Chaolong
C
Mo
Ying
Y
Wu
Danling
D
Qin
Jian
J
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D010349:Patient Compliance; D050397:Radiotherapy, Intensity-Modulated; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D002945:Cisplatin