title: A comparative study of locoregionally advanced nasopharyngeal carcinoma treated with intensity modulated irradiation and platinum-based chemotherapy.
abstract: OBJECTIVE
  To investigate the prognosis of three subgroups of locoregionally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy and platinum-based chemotherapy.
  
  
  METHODS
  Hundred and eighty-one consecutive patients with locoregionally advanced untreated nasopharyngeal carcinoma were retrospectively divided into three subgroups: locally advanced group (T3-4N0-1M0), regionally advanced group (T1-2N2-3M0) and the mixed group (T3-4N2-3M0). They were all treated with definitive intensity-modulated radiotherapy and platinum-based chemotherapy. Their prognosis were investigated and compared. Multivariate analysis was applied to identify the independent risk factors of study endpoints.
  
  
  RESULTS
  The 3-year locoregional control rates for locally advanced group, regionally advanced group, and the mixed group were 91.5%, 90.6% and 84.3% respectively, no significant difference was observed (P=0.656, P=0.429). The 3-year distant metastasis-free survival rates were 89.6%, 75.7% and 76.3%, respectively. The distant metastasis-free survival rate of the locally advanced group was significantly higher than the other two subgroups (P=0.028, P=0.028). The 3-year progression-free survival rates were 85.5%, 67.9% and 67.1% respectively with significance also favoring the locally advanced group (P=0.043, P=0.023). Nodal stage and the performance status were the independent risk factors of distant metastasis in the observed period.
  
  
  CONCLUSIONS
  In the context of intensity-modulated radiotherapy and platinum-based chemotherapy, the locally advanced group had a better prognosis compared with the regionally advanced group and the mixed group. Treatment stratification may be based on nodal stage.
authors.affiliation: Department of Radiation Oncology, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, 42# Baiziting, Xuanwu District, Nanjing 210009, People's Republic of China.
authors.forename: J H
authors.initials: JH
authors.lastname: Xu
authors.forename: W J
authors.initials: WJ
authors.lastname: Guo
authors.forename: X H
authors.initials: XH
authors.lastname: Bian
authors.forename: J F
authors.initials: JF
authors.lastname: Wu
authors.forename: X S
authors.initials: XS
authors.lastname: Jiang
authors.forename: Y S
authors.initials: YS
authors.lastname: Guo
authors.forename: X
authors.initials: X
authors.lastname: He
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D017713:Platelet Transfusion; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; C053989:nedaplatin; D017239:Paclitaxel; D005472:Fluorouracil
keywords: Carcinome localement évolué du nasopharynx; Chemotherapy; Chimiothérapie; IMRT; Locoregionally advanced nasopharyngeal carcinoma; Radiothérapie conformationnelle avec modulation d’intensité; Subgroup