title: Radiotherapy concurrently with weekly cisplatin, followed by adjuvant chemotherapy, for N2-3 nasopharyngeal cancer: a multicenter trial of the Forum for Nuclear Cooperation in Asia.
abstract: The purpose of this study was to evaluate the efficacy and toxicity of radiotherapy concurrently with weekly cisplatin, followed by adjuvant chemotherapy, for the treatment of N2-3 nasopharyngeal cancer (NPC) in Asian countries, especially regions of South and Southeast Asian countries where NPC is endemic. Between 2005 and 2009, 121 patients with NPC (T1-4 N2-3 M0) were registered from Vietnam, Malaysia, Indonesia, Thailand, The Philippines, China and Bangladesh. Patients were treated with 2D radiotherapy concurrently with weekly cisplatin (30 mg/m (2)), followed by adjuvant chemotherapy, consisting of cisplatin (80 mg/m(2) on Day 1) and fluorouracil (800 mg/m(2) on Days 1-5) for 3 cycles. Of the 121 patients, 56 patients (46%) required interruption of RT. The reasons for interruption of RT were acute non-hematological toxicities such as mucositis, pain and dermatitis in 35 patients, hematological toxicities in 11 patients, machine break-down in 3 patients, poor general condition in 2 patients, and others in 8 patients. Of the patients, 93% completed at least 4 cycles of weekly cisplatin during radiotherapy, and 82% completed at least 2 cycles of adjuvant chemotherapy. With a median follow-up time of 46 months for the surviving 77 patients, the 3-year locoregional control, distant metastasis-free survival and overall survival rates were 89%, 74% and 66%, respectively. No treatment-related deaths occurred. Grade 3-4 toxicities of mucositis, nausea/vomiting and leukopenia were observed in 34%, 4% and 4% of the patients, respectively. In conclusion, further improvement in survival and locoregional control is necessary, although our regimen showed acceptable toxicities.
authors.affiliation: Gunma University Heavy Ion Medical Center, Gunma University, Gunma, Japan. tohno@gunma-u.ac.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ohno
authors.forename: Dang Huy Quoc
authors.initials: DH
authors.lastname: Thinh
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.forename: C R Beena
authors.initials: CR
authors.lastname: Devi
authors.forename: Ngo Thanh
authors.initials: NT
authors.lastname: Tung
authors.forename: Kullathorn
authors.initials: K
authors.lastname: Thephamongkhol
authors.forename: Miriam Joy C
authors.initials: MJ
authors.lastname: Calaguas
authors.forename: Juying
authors.initials: J
authors.lastname: Zhou
authors.forename: Yaowalak
authors.initials: Y
authors.lastname: Chansilpa
authors.forename: Nana
authors.initials: N
authors.lastname: Supriana
authors.forename: Dyah
authors.initials: D
authors.lastname: Erawati
authors.forename: Parvin Akhter
authors.initials: PA
authors.lastname: Banu
authors.forename: Cho Chul
authors.initials: CC
authors.lastname: Koo
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tsujii
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001208:Asia / Q000453:epidemiology; D059248:Chemoradiotherapy / Q000401:mortality*; D017024:Chemotherapy, Adjuvant / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000628:therapy*; D015995:Prevalence; D011832:Radiation Injuries / Q000401:mortality*; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage; D020266:Radiotherapy, Conformal / Q000401:mortality*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D002945:Cisplatin