title: Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy.
abstract: OBJECTIVE
  To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngeal carcinoma, we compared the treatment outcomes of patients treated with curative radiotherapy with or without chemotherapy.
  
  
  METHODS
  From 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002 stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitals in South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvant chemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in 80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gy to 74.2 Gy (median, 70 Gy).
  
  
  RESULTS
  Median follow-up was 48 months (range, 7 to 97 months) for all patients. At the last follow-up, 13 patients had died and 32 had experienced treatment failure; locoregional failure occurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival, and overall survival were 86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that the significant prognostic factors were concurrent chemotherapy and N stage for locoregional relapse-free survival, concurrent chemotherapy for progression-free survival, and age and N stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improved distant metastasis-free survival.
  
  
  CONCLUSIONS
  Concurrent chemotherapy significantly improved 5-year locoregional relapse-free survival and progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvant chemotherapy failed to improve either.
authors: Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea.
authors: Min Kyu
authors: MK
authors: Kang
authors: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Dongryul
authors: D
authors: Oh
authors: Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Kwan Ho
authors: KH
authors: Cho
authors: Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Sung Ho
authors: SH
authors: Moon
authors: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors: Hong-Gyun
authors: HG
authors: Wu
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Dae-Seog
authors: DS
authors: Heo
authors: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Yong Chan
authors: YC
authors: Ahn
authors: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Keunchil
authors: K
authors: Park
authors: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Hyo Jung
authors: HJ
authors: Park
authors: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jun Su
authors: JS
authors: Park
authors: Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
authors: Ki Chang
authors: KC
authors: Keum
authors: Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
authors: Jihye
authors: J
authors: Cha
authors: Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
authors: Jun Won
authors: JW
authors: Kim
authors: Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Yeon-Sil
authors: YS
authors: Kim
authors: Department of Medical Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Jin Hyoung
authors: JH
authors: Kang
authors: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
authors: Young-Taek
authors: YT
authors: Oh
authors: Department of Radiation Oncology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Ji-Yoon
authors: JY
authors: Kim
authors: Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors: Sung Hwan
authors: SH
authors: Kim
authors: Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors: Jin-Hee
authors: JH
authors: Kim
authors: Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
authors: Chang Geol
authors: CG
authors: Lee
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000532:radiotherapy*; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents
keywords: Chemoradiotherapy; Chemotherapy; Nasopharyngeal carcinoma; Radiotherapy