title: Chemoradiotherapy with weekly low-dose docetaxel and cisplatin concurrent with radiation for patients with locally advanced nasopharyngeal carcinoma, followed by adjuvant chemotherapy for selected patients.
abstract: OBJECTIVE
  We investigated the efficacy and safety of concurrent chemoradiotherapy using weekly low-dose docetaxel and cisplatin in patients with locally advanced nasopharyngeal carcinoma.
  
  
  METHODS
  This was a retrospective analysis of 31 patients who were treated with this regimen from 2001 to 2014. Concurrent chemoradiotherapy consisted of radiotherapy with a total dose of 59.4-70.2 Gy plus weekly administration of docetaxel (5-10 mg/m2) and cisplatin (20 mg/m2), up to six cycles. At least two cycles of platinum-based adjuvant chemotherapy were prescribed for Stage IV and Stage III patients with partial response or stable disease after concurrent chemoradiotherapy.
  
  
  RESULTS
  Of the 31 patients, 28 (90%) completed concurrent chemoradiotherapy as planned. The overall complete response and partial response rates were 42% and 52%, respectively. Seventeen of the 21 patients who were prescribed adjuvant chemotherapy underwent it. After a median follow-up of 39.1 months for the 23 surviving patients, 9 (29%) developed locoregional recurrence or progression and 6 patients (19%) developed distant metastasis. The 3-year overall survival and progression-free survival rates were 76% and 56%, respectively. Univariate analyses revealed that clinical stage was a significant predictor of complete response, overall survival and progression-free survival. The most serious adverse events were mucositis during concurrent chemoradiotherapy and neutropenia during adjuvant chemotherapy.
  
  
  CONCLUSIONS
  This concurrent chemoradiotherapy protocol showed practical efficacy with high feasibility and acceptable toxicity. To improve the progression-free survival of patients with Stage IV disease who are treated by this protocol, changes to their treatment strategy should be considered.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Faculty of Medicine, Suita snakahara@ent.med.osaka-u.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakahara
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Faculty of Medicine, Suita.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hanamoto
authors.affiliation: Department of Radiation Oncology, Osaka University Faculty of Medicine, Suita, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Seo
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Faculty of Medicine, Suita.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyaguchi
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Faculty of Medicine, Suita.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Faculty of Medicine, Suita.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Tomiyama
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Faculty of Medicine, Suita.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshii
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Faculty of Medicine, Suita.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Takenaka
authors.affiliation: Department of Radiation Oncology, Osaka University Faculty of Medicine, Suita, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoshioka
authors.affiliation: Department of Radiation Oncology, Osaka University Faculty of Medicine, Suita, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Isohashi
authors.affiliation: Department of Radiation Oncology, Osaka University Faculty of Medicine, Suita, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Faculty of Medicine, Suita.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inohara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma; D059248:Chemoradiotherapy / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use*; D018572:Disease-Free Survival; D000077143:Docetaxel; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009503:Neutropenia / Q000209:etiology; D011829:Radiation Dosage; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D043823:Taxoids / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin
keywords: adjuvant chemotherapy; chemoradiotherapy; clinical stage; nasopharyngeal carcinoma