title: Concurrent chemoradiotherapy for T3-4 and N0-1 nasopharyngeal cancer: Asian multicenter trial of the Forum for Nuclear Cooperation in Asia.
abstract: The aim of this study was to evaluate the toxicity and efficacy of radiotherapy concurrent with weekly cisplatin for T3-4 and N0-1 nasopharyngeal cancer. Between 2005 and 2010, 70 patients with nasopharyngeal cancer (T3-4 N0-1 M0, World Health Organization Type 2-3) from Vietnam, Indonesia, Malaysia and Thailand were registered. Patients were treated with 2D radiotherapy concurrent with weekly cisplatin (30 mg/m(2)). Neither adjuvant nor induction chemotherapy was given. Ninety-three percent of the patients completed at least four cycles of weekly cisplatin during radiotherapy. The median total doses for the primary tumor and positive lymph nodes were 70 and 66 Gy, respectively. The median overall treatment time of concurrent chemoradiotherapy was 52 days. No treatment-related deaths occurred. Grade 3-4 acute toxicities of mucositis, nausea/vomiting and leukopenia were observed in 34%, 4% and 4% of patients, respectively. With a median follow-up time of 52 months for the 40 surviving patients, the 3-year local control, locoregional tumor control, distant metastasis-free survival and overall survival rates were 80%, 75%, 74% and 80%, respectively. In conclusion, the current results illustrate that our concurrent chemoradiotherapy regimen was feasible, but disease control remained insufficient. Further research is encouraged in order to improve clinical outcomes.
authors.affiliation: Gunma University Heavy Ion Medical Center, Gunma University, Gunma, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ohno
authors.affiliation: Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan masaru.wakatsuki@nifty.com.
authors.forename: Masaru
authors.initials: M
authors.lastname: Wakatsuki
authors.affiliation: Department of Radiation Oncology No. 3, Ho Chi Minh City Cancer Center, Ho Chi Minh City, Vietnam.
authors.forename: Dang Huy Quoc
authors.initials: DH
authors.lastname: Thinh
authors.affiliation: Head and Neck Radiation Department, National Cancer Hospital, Hanoi, Vietnam.
authors.forename: Ngo Thanh
authors.initials: NT
authors.lastname: Tung
authors.affiliation: Department of Radiotherapy, Dr Soetomo General Hospital, Surabaya, Indonesia.
authors.forename: Dyah
authors.initials: D
authors.lastname: Erawati
authors.affiliation: Department of Radiotherapy, Dr Cipto Mangunkusumo General Hospital, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: Nana
authors.initials: N
authors.lastname: Supriana
authors.affiliation: Department of Radiation Oncology, Sarawak General Hospital, Kuching, Malaysia.
authors.forename: C R
authors.initials: CR
authors.lastname: Beena Devi
authors.affiliation: Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kullathorn
authors.initials: K
authors.lastname: Thephamongkhol
authors.affiliation: Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Yaowalak
authors.initials: Y
authors.lastname: Chansilpa
authors.affiliation: Department of Radiation Oncology, St Luke's Medical Center, Quezon City, Philippines.
authors.forename: Miriam Joy C
authors.initials: MJ
authors.lastname: Calaguas
authors.affiliation: Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Xiaoting
authors.affiliation: Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Cao
authors.initials: C
authors.lastname: Jianping
authors.affiliation: Department of Radiation Oncology, Delta Hospitals Limited, Dhaka, Bangladesh.
authors.forename: Parvin Akhter
authors.initials: PA
authors.lastname: Banu
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
authors.forename: Chul-Koo
authors.initials: CK
authors.lastname: Cho
authors.affiliation: Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Karasawa
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tsujii
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia; D002277:Carcinoma; D059248:Chemoradiotherapy / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology* / Q000628:therapy*; D009367:Neoplasm Staging; D010349:Patient Compliance; D016896:Treatment Outcome
keywords: 2-dimensional radiotherapy; chemoradiotherapy; cisplatin; developing country; nasopharyngeal cancer