title: Non-endemic locoregionally advanced nasopharyngeal carcinoma: long-term outcome after induction plus concurrent chemoradiotherapy in everyday clinical practice.
abstract: The aim of this study was to evaluate the long-term outcome in Caucasian population of a non-endemic area treated for locoregionally advanced nasopharyngeal carcinoma (LA-NPC) with multidrug platinum-based induction plus concurrent chemoradiotherapy (IC/CCRT) in everyday clinical practice setting. Between May 1990 and July 2007, 75 patients with newly diagnosed histologically confirmed LA-NPC were given IC/CCRT. All patients were judged suitable to receive conventional fractionated course of radiotherapy to a dose of 70 Gy in 35 fractions (2 Gy per fraction). The intended chemotherapy regimen consisted in one cycle of induction chemotherapy followed by radiotherapy concomitantly with two cycles of chemotherapy. Each cycle of chemotherapy included cis-platinum, 100 mg/m(2), and continuous infusion of 5-fluorouracil, 1,000 mg/m(2)/d for 5 days. The median follow-up in survivors was 122 months. The complete response rate after CCRT was 90.7%. The main limiting toxicity was grade 3 and 4 pharyngeal mucositis (46.7%). Five-year cumulative rate of locoregional control (LRC), distant control (DC), overall survival (OS), and event-free survival (EFS) was 80.1, 82.2, 72.0, and 66.7%, respectively. Ten-year cumulative rate of LRC, DC, OS, and EFS was 73.4, 73.8, 57.1, and 55.2%, respectively. At multivariate analysis advanced N category and low hemoglobin levels at baseline were found to be independent predictors for both worse OS and EFS. In everyday clinical practice, treating LA-NPC with cisplatin-based IC/CCRT was relatively safe and long-term effective.
authors.affiliation: Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso Regional Hospital, Piazzale Ospedale 1, 31100, Treviso, Italy. paolo.boscolorizzo@unipd.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boscolo-Rizzo
authors.affiliation: Head and Neck Department, University of Trieste, Trieste, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Tirelli
authors.affiliation: Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso Regional Hospital, Piazzale Ospedale 1, 31100, Treviso, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Mantovani
authors.affiliation: Department of Radiation Oncology, Treviso Regional Hospital, Treviso, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Baggio
authors.affiliation: Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso Regional Hospital, Piazzale Ospedale 1, 31100, Treviso, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Lupato
authors.affiliation: Head and Neck Department, University of Trieste, Trieste, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Spinato
authors.affiliation: Department of Radiation Oncology, Treviso Regional Hospital, Treviso, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gava
authors.affiliation: Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso Regional Hospital, Piazzale Ospedale 1, 31100, Treviso, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Da Mosto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000628:therapy*; D012074:Remission Induction; D055815:Young Adult
chemical_list: D002945:Cisplatin; D005472:Fluorouracil
keywords: Concurrent chemoradiotherapy; Induction chemotherapy; Long-term outcome; Nasopharyngeal carcinoma; Radiotherapy; Toxicity