title: Concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: treatment outcomes of a prospective, multicentric clinical study.
abstract: OBJECTIVE
  To evaluate long-term outcome in locoregionally advanced nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy.
  
  
  METHODS
  Between January 2006 and August 2008, 249 patients with stage III-IVb NPC were treated by IMRT plus concurrent chemotherapy in this multicenter prospective study.
  
  
  RESULTS
  With a mean follow-up of 54.1 months, the 5-year actuarial rates of overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were 78.4%, 86.8%, 88.4%, 78.0%, respectively. There were 29 local recurrences, 25 regional recurrences and 52 distant metastases, respectively. Distant metastasis is the main cause of treatment failure. N-stage was an independent prognostic factor for LRFS, RRFS, DMFS and OS. Acute toxicity ⩾grade III mainly consisted of mucositis (34.9%), neutropenia (11.2%), xerostomia (5.6%), and dermatitis (5.2%). The main documented late toxicity was xerostomia, and the severity of xerostomia decreased over time. At 24 months after treatment, 13.2% of patients had grade 2 xerostomia, and none had grade 3 or 4 xerostomia.
  
  
  CONCLUSIONS
  IMRT with concurrent cisplatin chemotherapy resulted in encouraging rates of local and distant control and overall survival with acceptable rates of acute and limited rates of late toxicity in patients with locoregionally advanced NPC. Distant metastasis remained the main cause of failure. More effective systemic therapy should be explored for patients with advanced N-stage.
authors.affiliation: Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Fang
authors.initials: F
authors.lastname: Wu
authors.affiliation: Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China. Electronic address: 13807806008@163.com.
authors.forename: Rensheng
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China.
authors.forename: Heming
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Epidemiology and Social Medicine, Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wei
authors.affiliation: Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China.
authors.forename: Guosheng
authors.initials: G
authors.lastname: Feng
authors.affiliation: Department of Radiation Oncology, Liuzhou Worker Hospital, People's Republic of China.
authors.forename: Guisheng
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Guilin Medical University, People's Republic of China.
authors.forename: Meilian
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, First People's Hospital of Yulin City, People's Republic of China.
authors.forename: Haolin
authors.initials: H
authors.lastname: Yan
authors.affiliation: Department of Radiation Oncology, Wuzhou Red Cross Hospital, People's Republic of China.
authors.forename: Jinxian
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Hu
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use*; D015331:Cohort Studies; D003872:Dermatitis / Q000209:etiology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome; D014987:Xerostomia / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Clinical outcome; Concurrent chemoradiotherapy; Intensity-modulated radiotherapy; Nasopharyngeal carcinoma; Prospective study