Abstract
BackgroundWe aimed to compare the long-term survival outcomes and acute toxicity of cisplatin administered weekly versus every three weeks concurrently with intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).MethodsThis was a retrospective review of 154 patients with histologically proven, non-disseminated NPC who were treated using IMRT between January 2003 and December 2007. Seventy-three patients (47.4%) received 5–7 weeks of 30–40 mg/m2 cisplatin weekly; 81 patients (52.6%) received two or three cycles of 80 mg/m2 cisplatin every three weeks. IMRT was delivered at 68 Gy/30 fractions to the nasopharyngeal gross target volume and 60–66 Gy to the involved neck area.ResultsThe clinical characteristics and treatment factors of the two groups were well-balanced. The median follow-up was 74 months (range, 6–123 months), and the 5-year overall survival, disease-free survival, locoregional relapse-free survival, and distant metastasis–free survival rates were 85.2% vs. 78.9% (P = 0.318), 71.6% vs. 71.0% (P = 0.847), 93.5% vs. 92.6% (P = 0.904), and 80.9% vs. 80.1% (P = 0.925) for the group treated every three weeks and weekly, respectively. Subgroup analyses indicated no significant differences in the survival rates of the two groups among patients with early- or advanced-stage disease. The incidence of acute toxicities was similar between groups.ConclusionIMRT with concurrent cisplatin administered weekly or every three weeks leads to similar long-term survival outcomes and acute toxicity in NPC regardless of whether patients have early- or advanced-stage disease.
Highlights
Nasopharyngeal carcinoma (NPC) is highly prevalent in southern China; incidence rates range between 15 and 50 per100,000 individuals [1]
The National Comprehensive Cancer Network recommends that CCRT with cisplatin (CDDP) be delivered at an intermediate dose weekly or at a high dose at 3-week intervals for stage II–IVB
The Intergroup 0099 trial (INT-0099) [3] and nasopharyngeal carcinoma (NPC)-9901 trial [5] compared concurrent CDDP (100 mg/m2) every three weeks with radiation therapy (RT) alone; compliance to the intensive regimen was poor, and CCRT was associated with a high incidence of acute toxicity
Summary
Nasopharyngeal carcinoma (NPC) is highly prevalent in southern China; incidence rates range between 15 and 50 per100,000 individuals [1]. Nasopharyngeal carcinoma (NPC) is highly prevalent in southern China; incidence rates range between 15 and 50 per. Due to the anatomical location and radiosensitivity of NPC, radiation therapy (RT) is the mainstay (CCRT) confers survival benefit in locoregionally advanced NPC [4–11]. The National Comprehensive Cancer Network recommends that CCRT with cisplatin (CDDP) be delivered at an intermediate dose weekly or at a high dose at 3-week intervals for stage II–IVB. The Intergroup 0099 trial (INT-0099) [3] and NPC-9901 trial [5] compared concurrent CDDP (100 mg/m2) every three weeks with RT alone; compliance to the intensive regimen was poor, and CCRT was associated with a high incidence of acute toxicity. We aimed to compare the long-term survival outcomes and acute toxicity of cisplatin administered weekly versus every three weeks concurrently with intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC)
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