title: Comparison of concurrent chemoradiotherapy versus induction chemotherapy followed by radiation in patients with nasopharyngeal carcinoma.
abstract: OBJECTIVE
  The study aimed to evaluate the efficacy of concurrent chemoradiotherapy (CCRT) with platinum-based chemotherapy as a primary treatment for nasopharyngeal carcinoma (NPC) and to further compare the results of CCRT with these of neoadjuvant chemotherapy (NAC) followed by radiotherapy (RT).
  
  
  METHODS
  Before 1998, 21 patients with NPC received NAC followed by RT (NAC-RT). Between 1999 and 2008, a total of 25 NPC patients received CCRT. The CCRT group received a regimen including docetaxel (50 mg/m(2), day1), cisplatin (CDDP, 60 mg/m(2), day4) and continuous 5-fluorouracil (5-FU) infusion (600 mg/m(2), day 1-5), the TPF regimen, or a regimen including CDDP (60 mg/m(2), day4), continuous 5-FU infusion (600 mg/m(2), day 1-5), methotrexate (MTX, 30 mg/m(2), day 1) and leucovorin (LV, 20 mg/m(2), day 1-5), PFML regimen. The CCRT group received 2 cycles of chemotherapy during definitive RT. The NAC group of patients received a PFML regimen.
  
  
  RESULTS
  The overall response rate after CCRT was 96%. The 3-year and 5-year disease-specific survival rates were 75.6% and 60.1%, respectively. In patients receiving NAC-RT, the 3-year and 5-year disease-specific survival rates were 84.1% and 67.3%, respectively. There was no difference observed in terms of survival rates between the group receiving CCRT and that receiving NAC-RT.
  
  
  CONCLUSIONS
  CCRT with the TPF or PFML regimen was tolerable, and the NPC patients receiving this treatment showed excellent survival rates. In comparison to the group receiving NAC-RT, CCRT had no advantage in terms of the survival rate. In the future, the control of distant metastasis might play an important role in improving the survival rate of patients with advanced NPC receiving CCRT.
authors.affiliation: Department of Otolaryngology, and Head and Neck Surgery, Yokohama City University School of Medicine, 9-3 Fukuura, Kanazawa-Ku, Yokohama 236-0004, Japan. komatsu3@yokohama-cu.ac.jp
authors.forename: Masanori
authors.initials: M
authors.lastname: Komatsu
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tsukuda
authors.forename: Hideki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Choichi
authors.initials: C
authors.lastname: Horiuchi
authors.forename: Takahide
authors.initials: T
authors.lastname: Taguch
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takahashi
authors.forename: Gohshi
authors.initials: G
authors.lastname: Nishimura
authors.forename: Makiko
authors.initials: M
authors.lastname: Mori
authors.forename: Tatuo
authors.initials: T
authors.lastname: Niho
authors.forename: Junichi
authors.initials: J
authors.lastname: Ishitoya
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Mariko
authors.initials: M
authors.lastname: Hirama
authors.forename: Osamu
authors.initials: O
authors.lastname: Shiono
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002277:Carcinoma; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D060828:Induction Chemotherapy; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D020360:Neoadjuvant Therapy; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil; D008727:Methotrexate