J Korean Soc Ther Radiol Oncol.  1999 Dec;17(4):275-280.

Neoadjuvant Chemotherapy and Radiation Therapy inAdvanced Stage Nasopharyngeal Carcinoma

Affiliations
  • 1Department of Therapeutic Radiology, Seoul National University College of Medicine, Korea.
  • 2Institute of Radiation Medicine, Medical Research Center, Seoul National Univerisity, Korea.

Abstract

PURPOSE: To assess the feasibility and the toxicity of the neoadjuvant chemotherapy on the treatment of patients with locoregionally advanced nasopharyngeal carcinoma.
MATERIALS AND METHODS
We analyzed 77 previouly untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with neoadjuvant chemotherapy followed by radiation therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows : AJCC stage III-2, stage IV-75, Sixty-six patients received infusion of 5-FU (1000 mg/m2, on Day 1~5) and cisplatin (100 mg/m2, on Day 1), eleven patients received infusion of 5-FU (1000 mg/m2, on Day 1~5) and carboplatin (300 mg/m2, on Day 1), as neoadjuvant chemotherapy prior to radiation therapy. The median follow-up for surviving patients was 44 months.
RESULTS
The overall chemotherapy response rates were 87%. The toxicities of chemotherapy were mild. Only 3 patients experienced Grade 3 toxicities (1 for cytopenia, 2 for nausea/vomiting). The degree of radiation induced mucositis was not severe, and then patients developed Grade 2 mucositis. The 5-year overall survival rates were 68% and the 5-year disease free survival rates were 65%. The 5-year overall survival rates were 68% and the 5-year disease free survival rates were 65%. The 5-year freedom from distant metastasis rates were 82% and 5-year locoregional control rates were 75%.
CONCLUSION
This single institution experience suggests that neoadjuvant chemotherapy improves overall survival and disease free survival for patients with advanced stage nasopharyngeal carcinoma without increase of toxicity.

Keyword

Nasopharyngeal carcinoma; Neoadjuvant chemotherapy; Radiation therapy

MeSH Terms

Carboplatin
Cisplatin
Disease-Free Survival
Drug Therapy*
Fluorouracil
Follow-Up Studies
Freedom
Humans
Mucositis
Neoplasm Metastasis
Seoul
Survival Rate
Carboplatin
Cisplatin
Fluorouracil
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