Radiat Oncol J.  2019 Jun;37(2):67-72. 10.3857/roj.2019.00311.

Less is more: role of additional chemotherapy to concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal cancer management

Affiliations
  • 1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ahnyc@skku.edu

Abstract

Concurrent chemoradiation therapy (CCRT) has played the most important and central role in the definitive therapy for the patients with locoregionally advanced stage nasopharynx cancer. The addition of induction chemotherapy (IC) or adjuvant chemotherapy (AC) to CCRT have been widely accepted with the rationale of improving distant control in the clinical practices. This review article investigated the role of IC and AC based on 11 recent meta-analysis publications, and found that the clinical benefits obtained by the additional IC or AC to CCRT, at the cost of the increased risks of more frequent and more severe side effects, seemed not big enough. More intervention is not always better, however, less seems frequently good enough. The author would speculate that "˜less is more' and would advocate CCRT alone as the current standard.

Keyword

Chemotherapy; Radiation therapy; Nasopharynx cancer

MeSH Terms

Chemoradiotherapy*
Chemotherapy, Adjuvant
Drug Therapy*
Humans
Induction Chemotherapy
Nasopharyngeal Neoplasms*
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