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1. Kong L, Lu JJ, Hu C, Guo X, Wu Y, Zhang Y: The risk of second primary tumors in patients with nasopharyngeal carcinoma after definitive radiotherapy. Cancer; 2006 Sep 15;107(6):1287-93
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  • [Title] The risk of second primary tumors in patients with nasopharyngeal carcinoma after definitive radiotherapy.
  • BACKGROUND: Second primary tumors (SPTs) have a substantial impact on survival in cancer patients.
  • However, risk factors for SPTs have not been documented well, especially in nasopharyngeal carcinoma (NPC).
  • The objective of this retrospective analysis was to evaluate such risks in patients with NPC after they received definitive radiation treatment.
  • METHODS: Three hundred twenty-six consecutive patients with pathologically confirmed, nonmetastatic, undifferentiated NPC who received treatment between January 1, 1994 and December 30, 1995 were analyzed.
  • All patients were restaged in accordance with the 2002 American Joint Committee on Cancer staging classification.
  • There were 18 patients (5.5%) with Stage I NPC, 152 patients (46.6%) with Stage II NPC, 101 patients (31.0%) with Stage III NPC, and 55 patients (16.9%) with Stage IVA or IVB NPC at initial diagnosis.
  • All patients received definitive radiotherapy with either Cobalt-60 or megavoltage therapy.
  • High-dose-rate brachytherapy was given to 23 patients either as part of their primary treatment or as adjuvant treatment for residual lesions.
  • Seventeen patients (5.2%) developed SPTs, for an average annual rate of 1.0%, and the 5-year cumulative incidence was 5.8%.
  • Multivariate analysis showed that age was the only independent risk factor for developing SPTs after RT for NPC.
  • Other factors, including gender, tumor or lymph node classification, chemotherapy, total radiation dose to the nasopharynx, reirradiation, and adjuvant brachytherapy did not influence the risk of SPTs.
  • CONCLUSIONS: SPTs in patients with NPC occurred preferentially in the UADT and tended to develop within the irradiated field >5 years after patients received radiation.
  • Older patients with NPC (age >or=50 years) may be at increased risk.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Neoplasms, Second Primary / etiology. Radiotherapy / adverse effects
  • [MeSH-minor] Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Retrospective Studies. Risk Factors. Time Factors

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  • [Copyright] (c) 2006 American Cancer Society.
  • (PMID = 16909425.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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2. Chen WC, Jackson A, Budnick AS, Pfister DG, Kraus DH, Hunt MA, Stambuk H, Levegrun S, Wolden SL: Sensorineural hearing loss in combined modality treatment of nasopharyngeal carcinoma. Cancer; 2006 Feb 15;106(4):820-9
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  • [Title] Sensorineural hearing loss in combined modality treatment of nasopharyngeal carcinoma.
  • BACKGROUND: Combined modality therapy has become the standard of care for nasopharyngeal carcinoma, yet the combined ototoxic effects of radiation and cisplatin are poorly understood.
  • The incidence and severity of sensorineural hearing loss (SNHL) with combined modality therapy was evaluated and the dose-response relation between radiation and hearing loss was investigated.
  • METHODS: Patients with newly diagnosed AJCC Stage II-IVB nasopharynx carcinoma treated from 1994-2003 were identified.
  • All patients were treated with conformal radiotherapy to 70 Gy and received platinum-based chemotherapy similar to the Intergroup 0099 trial.
  • Mean cochlear dose (Dmean) ranged from 28.4-70.0 Gy (median, 48.5 Gy).
  • There was an increased risk of SNHL for ears receiving Dmean > 48 Gy compared with those receiving < or = 48 Gy at all frequencies within the range of speech (P = 0.04).
  • Using univariate logistic regression analysis, Dmean to the cochlea, cycles of cisplatin, and time postradiotherapy were independently significant factors in determining the incidence of SNHL (P = 0.02, P = 0.03, and P = 0.04, respectively).
  • In univariate and multivariate linear regression analysis, Dmean was statistically significant at all frequencies in affecting degree of SNHL, whereas the significance of cisplatin and time was variable.
  • CONCLUSIONS: There was a significant increase in risk of SNHL among patients receiving > 48 Gy, suggesting a threshold in cochlear radiation dose-response in the setting of combined modality therapy.
  • This dose should serve as a Dmean constraint maximum for intensity-modulated radiotherapy treatment of nasopharynx carcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma / drug therapy. Carcinoma / radiotherapy. Hearing Loss, Sensorineural / etiology. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Audiometry. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy / adverse effects. Dose-Response Relationship, Radiation. Female. Humans. Male. Middle Aged. Radiotherapy, Conformal / adverse effects. Retrospective Studies. Severity of Illness Index

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  • [Copyright] Copyright 2006 American Cancer Society.
  • (PMID = 16421885.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P01-CA-59017
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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3. Leung SF, Chan AT, Zee B, Ma B, Chan LY, Johnson PJ, Lo YM: Pretherapy quantitative measurement of circulating Epstein-Barr virus DNA is predictive of posttherapy distant failure in patients with early-stage nasopharyngeal carcinoma of undifferentiated type. Cancer; 2003 Jul 15;98(2):288-91
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  • [Title] Pretherapy quantitative measurement of circulating Epstein-Barr virus DNA is predictive of posttherapy distant failure in patients with early-stage nasopharyngeal carcinoma of undifferentiated type.
  • BACKGROUND: Patients with International Union Against Cancer (UICC) Stage I-II nasopharyngeal carcinoma (NPC) appear to have a relatively favorable prognosis and generally are excluded from trials of combined modality treatment.
  • More recently, plasma/serum cell-free Epstein-Barr virus (EBV) DNA has been shown to be measurable in the majority of NPC patients at the time of diagnosis, and appears to have prognostic significance.
  • However, within Stage I-II disease, in which failure events are infrequent, the prognostic impact of the pretreatment EBV DNA level has not been addressed to our knowledge.
  • This issue has management implications because different therapeutic strategies currently are employed for patients with good-risk and those with poor-risk NPC.
  • METHODS: A cohort of 90 patients with UICC Stage I-II NPC (World Health Organization Grade 2/3 histology) had their pretherapy plasma/serum EBV DNA levels determined by a quantitative polymerase chain reaction assay and correlated with the probability of posttherapy failure.
  • All patients received radiation therapy only, except for three patients who also received concurrent chemotherapy.
  • Kaplan-Meier plots of the probability of locoregional failure, distant failure, and cancer-specific survival were compared with reference to clinical stage and EBV DNA levels.
  • RESULTS: With a median follow-up time of 45 months, 12 patients and 7 patients, respectively, had developed locoregional and distant failures, including 2 patients with both local and distant failures.
  • The probability of distant failure was significantly higher in patients with high (>4000 copies/mL plasma) compared with low EBV DNA levels (P=0.0001, log-rank test) and for Stage IIB disease compared with Stage I and Stage IIA disease combined (P=0.0149, log-rank test), but was not significantly different between patients with Stage II and those with Stage I disease.
  • Approximately 35% of patients with Stage IIB disease were in the at-risk group for distant failure, as identified by high EBV DNA levels.
  • CONCLUSIONS: Within a group of patients with UICC Stage I-II NPC, the pretherapy plasma EBV DNA level was found to identify a poor-risk group with a probability of distant failure similar to that of patients with advanced stage disease.
  • This group of patients may warrant management considerations currently applicable only to cases of Stage III-IV disease.
  • The prognostic significance of designating Stage IIB disease as per the 1997 UICC staging was confirmed, although the pretherapy EBV DNA level appears to be a more powerful prognostic discriminator in patients with early-stage NPC.
  • [MeSH-major] DNA, Viral / blood. Epstein-Barr Virus Infections / complications. Herpesvirus 4, Human / isolation & purification. Nasopharyngeal Neoplasms / blood. Nasopharyngeal Neoplasms / virology
  • [MeSH-minor] Humans. Neoplasm Metastasis. Neoplasm Staging. Polymerase Chain Reaction. Prognosis. Treatment Failure

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  • [Copyright] Copyright 2003 American Cancer Society.
  • (PMID = 12872347.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Viral
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4. Liu WS, Su MC, Wu MF, Tseng HC, Kuo HC: Nasopharyngeal carcinoma treated with precision-oriented radiation therapy techniques including intensity-modulated radiotherapy: preliminary results. Kaohsiung J Med Sci; 2004 Feb;20(2):49-55
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  • [Title] Nasopharyngeal carcinoma treated with precision-oriented radiation therapy techniques including intensity-modulated radiotherapy: preliminary results.
  • This paper reports preliminary results with intensity-modulated radiotherapy (IMRT) in nasopharyngeal carcinoma (NPC).
  • Between August 2000 and May 2001, we treated 19 patients with NPC using IMRT.
  • Twelve patients had stage I-II disease and seven had stage III-IV disease.
  • Six patients received 9.0-19.8 Gy three-dimensional conformal radiotherapy (3D-CRT) before IMRT and 18 patients received a brachytherapy boost after IMRT.
  • The mean follow-up time was 13.0 months.
  • All patients with stage II-IV disease except one received two cycles of chemoradiotherapy with cisplatin and 5-fluorouracil (5-FU) during radiotherapy, followed by two to four cycles of chemotherapy after radiotherapy.
  • Tumor response was assessed using clinical examination and computerized tomography or magnetic resonance imaging.
  • The mean doses administered to the gross tumor volume and clinical tumor volume were 70.9 Gy and 63.2 Gy, respectively.
  • The mean doses administered to the right and left parotid glands were 38.1 Gy and 38.6 Gy, respectively.
  • Grade III mucositis developed during chemoradiotherapy in 15 patients (79%).
  • In addition, clinical grade I xerostomia was recorded in nine patients, grade II in nine, and grade III in one.
  • This study demonstrated that 3D-CRT, IMRT, intracavitary brachytherapy, and chemotherapy are effective and safe methods to treat NPC.
  • Although IMRT treatment spared parotid gland function, its efficacy may be significantly influenced by disease stage and location of the neck lymph nodes.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Antimetabolites, Antineoplastic / therapeutic use. Combined Modality Therapy. Dose Fractionation. Female. Fluorouracil / therapeutic use. Follow-Up Studies. Humans. Male. Middle Aged. Radiotherapy / methods. Radiotherapy, Conformal / methods. Treatment Outcome. Xerostomia / etiology

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  • (PMID = 15481551.001).
  • [ISSN] 1607-551X
  • [Journal-full-title] The Kaohsiung journal of medical sciences
  • [ISO-abbreviation] Kaohsiung J. Med. Sci.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China (Republic : 1949- )
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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5. Mertens R, Granzen B, Lassay L, Bucsky P, Hundgen M, Stetter G, Heimann G, Weiss C, Hess CF, Gademann G: Treatment of nasopharyngeal carcinoma in children and adolescents: definitive results of a multicenter study (NPC-91-GPOH). Cancer; 2005 Sep 1;104(5):1083-9
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  • [Title] Treatment of nasopharyngeal carcinoma in children and adolescents: definitive results of a multicenter study (NPC-91-GPOH).
  • BACKGROUND: Preliminary results of combined neoadjuvant chemotherapy, radiotherapy, and postradiation interferon beta (IFN-beta) in children and adolescents with nasopharyngeal carcinoma, especially in high-risk patients, have been promising.
  • METHODS: From 1992 to 2003, 59 patients (58 high-risk patients and 1 low-risk patient, median age 13 yrs; range, 8-25 yrs) were treated in the GPOH-NPC-91 study.
  • The Stage II patient received irradiation as initial therapy.
  • Fifty-eight patients received preradiation chemotherapy with methotrexate, cisplatin, and 5-fluorouracil.
  • The cumulative radiation dose to primary sites was 59.4 Gy, a total dose of 45 Gy was delivered to the neck area.
  • After irradiation, all patients were treated with 10(5) U recombinant IFN-beta/kg body weight 3 times a week for 6 months.
  • RESULTS: After combination therapy, complete response was accomplished in 58 patients.
  • In one patient, there was tumor progression during chemotherapy.
  • In 3 patients, distant metastases were observed 14, 15, and 18 months after diagnosis, respectively.
  • One patient had a local relapse 12 months after diagnosis.
  • Chemotherapy-related toxicity was mucositis Grade II, III, or IV in all patients and acute cardiotoxicity in 2 (3.5%) of the patients.
  • Nephrotoxicity Grade I-II occurred in 8.8% of patients.
  • CONCLUSIONS: The combination of initial chemotherapy, radiotherapy, and IFN-beta results in an excellent outcome.
  • These results strongly support the development of a future treatment strategy along this line.
  • [MeSH-major] Nasopharyngeal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Combined Modality Therapy. Female. Humans. Interferon-beta / therapeutic use. Male. Neoplasm Staging. Radiotherapy Dosage

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  • (PMID = 15999363.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 77238-31-4 / Interferon-beta
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6. Tan SB, Machin D, Tai BC, Foo KF, Tan EH: A Bayesian re-assessment of two Phase II trials of gemcitabine in metastatic nasopharyngeal cancer. Br J Cancer; 2002 Mar 18;86(6):843-50
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  • [Title] A Bayesian re-assessment of two Phase II trials of gemcitabine in metastatic nasopharyngeal cancer.
  • The Simon two-stage minimax design is a popular statistical design used in Phase II clinical trials.
  • This paper presents an alternative, Bayesian, approach to the design and analysis of Phase II clinical trials.
  • In particular, we consider how a Bayesian approach could have affected the design, analysis and interpretation of two parallel Phase II trials of the National Cancer Centre Singapore, on the activity of gemcitabine in chemotherapy-naïve and in previously treated patients with metastatic nasopharyngeal carcinoma.
  • In particular, using a Bayesian trial design, we were able to take into account the results of the parallel trial results when deciding whether to continue each trial beyond the interim stage.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Bayes Theorem. Deoxycytidine / analogs & derivatives. Deoxycytidine / therapeutic use. Nasopharyngeal Neoplasms / drug therapy

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  • [Copyright] Copyright 2002 Cancer Research UK
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  • (PMID = 11953813.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Controlled Clinical Trial; Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
  • [Other-IDs] NLM/ PMC2364147
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7. Rodriguez-Galindo C, Wofford M, Castleberry RP, Swanson GP, London WB, Fontanesi J, Pappo AS, Douglass EC: Preradiation chemotherapy with methotrexate, cisplatin, 5-fluorouracil, and leucovorin for pediatric nasopharyngeal carcinoma. Cancer; 2005 Feb 15;103(4):850-7
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  • [Title] Preradiation chemotherapy with methotrexate, cisplatin, 5-fluorouracil, and leucovorin for pediatric nasopharyngeal carcinoma.
  • BACKGROUND: Nasopharyngeal carcinoma (NPC) is rare in children, accounting for <1% of all cases.
  • Treatment most commonly includes radiotherapy but long-term side effects of such treatment can produce devastating cosmetic and functional sequelae in children.
  • Chemotherapy may help to decrease the radiotherapy dose and limit the side effects of local therapies.
  • However, little is known regarding the chemosensitivity of NPC tumors in pediatric patients.
  • METHODS: Patients with American Joint Committee on Cancer (AJCC) Stage I/II disease (Stratum 01) received irradiation only.
  • Patients with AJCC Stage III/IV disease (Stratum 02) received 4 courses of preradiation chemotherapy comprising methotrexate (120 mg/m2) on Day 1, with cisplatin (100 mg/m2) 24 hours later, 5-fluorouracil 1000 mg/m2 per day as a continuous infusion for 3 days, and leucovorin 25 mg/m2 every 6 hours for 6 doses.
  • Irradiation was given after chemotherapy and consisted of 50.4 gray (Gy) to the upper neck and 45.0 Gy to the lower neck, with a boost to the primary tumor and positive lymph nodes for a total dose of 61.2 Gy.
  • Two-thirds of the patients developed Grade 3-4 mucositis during chemotherapy.
  • The overall response rate to induction chemotherapy was 93.7%.
  • CONCLUSIONS: The current study demonstrated that childhood NPC was sensitive to chemotherapy and that chemotherapy before irradiation was feasible.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma / drug therapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Antineoplastic Agents / adverse effects. Cisplatin / adverse effects. Combined Modality Therapy. Epstein-Barr Virus Infections. Fluorouracil / adverse effects. Herpesvirus 4, Human. Humans. Leucovorin / adverse effects. Methotrexate / adverse effects. Survival Rate

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  • [Copyright] Copyright (c) 2005 American Cancer Society.
  • (PMID = 15641027.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; YL5FZ2Y5U1 / Methotrexate
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8. Lu JJ, Shakespeare TP, Thiagarajan A, Zhang X, Liang L, Tan S: Prospective phase II trial of concomitant boost radiotherapy for stage II nasopharyngeal carcinoma: an evaluation of response and toxicity. Laryngoscope; 2005 May;115(5):806-10
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  • [Title] Prospective phase II trial of concomitant boost radiotherapy for stage II nasopharyngeal carcinoma: an evaluation of response and toxicity.
  • INTRODUCTION: Stage II nasopharyngeal carcinoma (NPC) treated with conventionally fractionated radiotherapy results in loco-regional control of around 80%.
  • This report aims to document the outcome of Stage II NPC patients treated with external beam radiotherapy delivered using an accelerated concomitant boost (C-Boost) schedule.
  • METHODS AND MATERIALS: Twenty-five 1997 AJCC Stage II NPC patients were enrolled and analyzed in this preliminary report.
  • The primary tumor and clinically involved nodes received a total dose of 72 Gy in 42 fractions.
  • C-Boost for gross disease consisted of 18 Gy in 12 fractions commencing on day 19 and was delivered at least 6 hours after the first dose.
  • Two developed distant metastases for which they received chemotherapy.
  • One died from systemic disease after refusing treatment for persistent neck lymphadenopathy.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy

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  • (PMID = 15867644.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
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9. Chen M, Lin S, Zheng W: [Therapeutic effect of medical therapy upon undifferentiated nasopharyngeal carcinoma: analysis of 149 cases]. Zhonghua Yi Xue Za Zhi; 2001 Dec 25;81(24):1488-9
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  • [Title] [Therapeutic effect of medical therapy upon undifferentiated nasopharyngeal carcinoma: analysis of 149 cases].
  • OBJECTIVE: To study the therapeutic effect and prognosis of undifferentiated nasopharyngeal carcinoma.
  • METHODS: 149 patients with undifferentiated nasopharyngeal carcinoma, 4 at stage I, 33 at stage II, 73 at stage III, and 39 at stage IV according to the Fuzhou Staging Criteria of Nasopharyngeal Carcinoma 1992, were treated mainly by radiotherapy from 1999 to 2000: 78 of them underwent radiotherapy alone, 32 underwent radiotherapy combined with induced chemotherapy, and 39 underwent radiotherapy combined with synchronized chemotherapy.
  • Relevant clinical data, especially the therapeutic effect upon and prognosis of the type, were analyzed.
  • RESULTS: Undifferentaited nasopharyngeal carcinoma accounts for 3.58% of nasopharyngeal carcinoma and was with a 5-year overall survival rate (OS) of 64.48%, a disease-free survival rate (DFS) of 60.35%, a distance-metastasis-free (DMF) survival rate of 77.05%, and a local recurrence free (LRF) survival rate of 80.13%.
  • The key factors influencing prognosis were the stage of N and stage of international classification of cancer based on TNM.
  • CONCLUSION: Undifferentiated nasopharyngeal carcinoma is a rare type.
  • Its prognosis is influenced mainly by the stage of N and TNM.
  • Treatment maninly on radiotherapy is effective.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Prognosis. Retrospective Studies

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  • (PMID = 16200771.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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10. Cheng SH, Tsai SY, Yen KL, Jian JJ, Chu NM, Chan KY, Tan TD, Cheng JC, Hsieh CY, Huang AT: Concomitant radiotherapy and chemotherapy for early-stage nasopharyngeal carcinoma. J Clin Oncol; 2000 May;18(10):2040-5
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  • [Title] Concomitant radiotherapy and chemotherapy for early-stage nasopharyngeal carcinoma.
  • PURPOSE: Early-stage nasopharyngeal carcinoma (NPC) continues to carry a failure rate of 15% to 30% when treated with radiotherapy alone; the benefit of concomitant radiotherapy and chemotherapy (CCRT) in early-stage NPC is unclear.
  • The purpose of this report is to describe our efforts to improve treatment outcome in early-stage NPC after CCRT.
  • PATIENTS AND METHODS: Of 189 newly diagnosed NPC patients without evidence of distant metastases who were treated in our institution between 1990 and 1997, 44 presented with early-stage (stage I and II) disease according to the American Joint Committee on Cancer (AJCC) 1997 NPC staging system.
  • Each patient's head and neck area was evaluated by magnetic resonance imaging or computed tomography.
  • Radiotherapy was administered at 2 Gy per fraction per day, Monday through Friday, for 35 fractions for a total dose of 70 Gy.
  • Chemotherapy consisting of cis-diamine-dichloroplatinum and fluorouracil was delivered simultaneously with radiotherapy in weeks 1 and 6 and sequentially for two monthly cycles after radiotherapy.
  • RESULTS: Patients who were treated with radiotherapy alone primarily had stage I disease, whereas none of those who were treated with CCRT had stage I disease (11 of 12 patients v none of 32 patients; P =.001).
  • CONCLUSION: Our results reveal excellent prognosis of AJCC 1997 stage II NPC treated with CCRT.
  • Stage II patients with a greater tumor burden treated with CCRT showed an equal disease-free survival, compared with stage I patients treated with radiotherapy alone.
  • A prospective randomized trial is underway to confirm the role of CCRT in stage II NPC.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / adverse effects. Cisplatin / therapeutic use. Combined Modality Therapy. Disease-Free Survival. Female. Fluorouracil / therapeutic use. Humans. Male. Middle Aged. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 10811668.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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11. Guo L, Lin HX, Li FY, Li Q, Qiu F, Luo DH, Guo X, Hong MH: [Phase I study of capecitabine with concurrent radiotherapy in early-stage nasopharyngeal carcinoma]. Zhonghua Zhong Liu Za Zhi; 2004 Apr;26(4):250-3
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  • [Title] [Phase I study of capecitabine with concurrent radiotherapy in early-stage nasopharyngeal carcinoma].
  • OBJECTIVE: To evaluate the dose-limiting toxicity (DLT), efficacy and maximum tolerated dose (MTD) of capecitabine with concurrent radiotherapy in patients with node-positive stage II nasopharyngeal cancer.
  • METHODS: From August 2002 to June 2003, 30 patients with node-positive stage II T(2)N(1)M(0) nasopharyngeal cancer were retrospectively reviewed.
  • Radiotherapy of 68 - 72 Gy/34 - 36 fractions was delivered to the nasopharynx and 64 - 70 Gy/32 - 35 fractions to the node-positive area.
  • Capecitabine was administered orally on day 1 of radiotherapy by an intermittent schedule (14 days treatment; 7-day rest) at 3 weekly intervals for two cycles.
  • Dose escalation was done after six patients had completed 2 cycles of chemotherapy at the previous dose level with DLT assessed.
  • The CR response rate of the node-positive area and of the nasopharynx were 50.0% (14/28) and 46.4% (13/28).
  • The toxicity of grade I and II was hand-foot syndrome (4/28), fatigue (14/28), nausea and vomiting (19/28), diarrhea (5/27), and weight loss (21/28).
  • This regimen is tolerable and valid for nasopharyngeal carcinoma.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Deoxycytidine / analogs & derivatives. Deoxycytidine / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Capecitabine. Combined Modality Therapy. Dose-Response Relationship, Drug. Female. Fluorouracil / analogs & derivatives. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Stomatitis / chemically induced. Thrombocytopenia / chemically induced

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  • (PMID = 15312392.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; U3P01618RT / Fluorouracil
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12. Portaluri M, Fucilli FI, Castagna R, Bambace S, Pili G, Tramacere F, Russo D, Francavilla MC: Three-dimensional conformal radiotherapy for locally advanced (Stage II and worse) head-and-neck cancer: dosimetric and clinical evaluation. Int J Radiat Oncol Biol Phys; 2006 Nov 15;66(4):1036-43
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  • [Title] Three-dimensional conformal radiotherapy for locally advanced (Stage II and worse) head-and-neck cancer: dosimetric and clinical evaluation.
  • PURPOSE: To evaluate the dosimetric parameters of three-dimensional conformal radiotherapy (3D-CRT) in locally advanced head-and-neck tumors (Stage II and above) and the effects on xerostomia.
  • METHODS AND MATERIALS: A total of 49 patients with histologically proven squamous cell cancer of the head and neck were consecutively treated with 3D-CRT using a one-point setup technique; 17 had larynx cancer, 12 oropharynx, 12 oral cavity, and 6 nasopharynx cancer; 2 had other sites of cancer.
  • Of the 49 patients, 41 received postoperative RT and 8 definitive treatment.
  • Also, 13 were treated with cisplatin-based chemotherapy before and during RT; in 6 cases, 5-fluorouracil was added.
  • The follow-up time was 484-567 days (median, 530 days).
  • The mean dose to the primary planning target volume was 49.54 +/- 4.82 Gy (51.53 +/- 5.47 Gy for larynx cases).
  • The average dose to the contralateral parotid gland was approximately 38 Gy (30 Gy for larynx cases).
  • The maximal dose to the spinal cord was 46 Gy.
  • A Grade 0 Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer xerostomia score corresponded to a mean dose of 30 Gy to one parotid gland.
  • With a mean dose of approximately 30 Gy to the contralateral parotid, we observed no or mild xerostomia.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Head and Neck Neoplasms / radiotherapy. Radiometry / methods. Radiotherapy Planning, Computer-Assisted / methods. Radiotherapy, Conformal / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Body Burden. Female. Humans. Male. Middle Aged. Radiotherapy Dosage. Relative Biological Effectiveness. Treatment Outcome

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  • (PMID = 16750321.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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13. Hao SP, Tsang NM, Chang KP, Hsu YS, Chen CK, Fang KH: Nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 53 patients and prognostic factors. Acta Otolaryngol; 2008 Apr;128(4):473-81
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  • [Title] Nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 53 patients and prognostic factors.
  • CONCLUSIONS: Salvage surgery is a justified treatment for primary recurrence of nasopharyngeal carcinoma (NPC).
  • Skull base surgery can play a role in rescuing patients with more advanced local recurrence of NPC.
  • OBJECTIVES: The purpose of this study was to report the local control and overall survival outcome of patients with (NPC) with local failure who received salvage nasopharyngectomy and to identify prognostic factors.
  • PATIENTS AND METHODS: Fifty-three consecutive patients who had primary recurrence of NPC and underwent salvage surgery with curative intention from July 1993 to December 2006 were retrospectively reviewed.
  • The follow-up time ranged from 5.1 to 142.2 months.
  • The numbers of cases of recurrent NPC stage were as follows: stage I, 26; stage II, 9; stage III, 10 and stage IV, 8.
  • Fifty patients had one course of radiation therapy while 3 had two courses of radiation therapy before the salvage surgery.
  • Postoperative adjuvant treatment included radiation therapy, 4 cases; radiosurgery, 8 cases; concurrent chemoradiation therapy, 7 cases; and chemotherapy, 2 cases.
  • RESULTS: The 5-year local control rates were T1, 58.3%; T2, 27.8%; T3, 53.3%; T4, 75.0%; and all stages, 53.6%.
  • The 5-year overall survival rates were stage I, 64.8%; stage II, 38.1%; stage III, 25.9%; stage IV, 46.9%; and all stages, 48.7%.
  • Multivariate analysis revealed that gender, margin status, adjuvant treatment type and parapharyngeal space involvement were significant impact factors of local control, whereas dura or brain involvement, local recurrence and adjuvant treatment type were significant impact factors of survival.
  • [MeSH-major] Carcinoma / surgery. Nasopharyngeal Neoplasms / surgery. Neoplasm Recurrence, Local / surgery. Pharyngectomy / methods
  • [MeSH-minor] Adult. Aged. Biopsy. Endoscopy / methods. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Rate / trends. Taiwan / epidemiology. Time Factors. Tomography, X-Ray Computed

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  • (PMID = 18368585.001).
  • [ISSN] 0001-6489
  • [Journal-full-title] Acta oto-laryngologica
  • [ISO-abbreviation] Acta Otolaryngol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Norway
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14. Prasad U, Wahid MI, Jalaludin MA, Abdullah BJ, Paramsothy M, Abdul-Kareem S: Long-term survival of nasopharyngeal carcinoma patients treated with adjuvant chemotherapy subsequent to conventional radical radiotherapy. Int J Radiat Oncol Biol Phys; 2002 Jul 1;53(3):648-55
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  • [Title] Long-term survival of nasopharyngeal carcinoma patients treated with adjuvant chemotherapy subsequent to conventional radical radiotherapy.
  • PURPOSE: To assess the long-term survival of patients with nasopharyngeal carcinoma (NPC) who were treated with conventional radical radiotherapy (RT) followed by adjuvant chemotherapy.
  • METHODS AND MATERIALS: Ninety-one newly diagnosed patients with Stage III and IV (American Joint Committee on Cancer, 1988) NPC, seen at the University of Malaya Medical Center, Kuala Lumpur, Malaysia between January 1992 and May 1997, were treated with RT followed by adjuvant chemotherapy.
  • The tumor dose was 70 Gy delivered in 35 fractions, 5 fractions weekly.
  • Three cycles of chemotherapy, each consisting of 5-fluorouracil, 1 g/m(2)/d on Days 1-4 and cisplatin 100 mg/m(2) on Day 1, were administered 3 weeks after RT completion.
  • Thirty-six patients had Stage II, 10 had Stage III, and 45 had Stage IV disease (AJCC 1997 staging system).
  • The 3-year overall survival rate for Stage II was 94.3%; it was 80% for Stage III and 79.8% for Stage IV (p = 0.0108).
  • The 3-year DFS rate for Stage II was 90%; it was 80% for Stage II and 65% for Stage IV.
  • The rate of distant failure for Stage IV was 8.9%.
  • CONCLUSION: Radical RT followed by adjuvant chemotherapy was effective in our patients with locoregionally advanced NPC.
  • The long-term results appear encouraging, even for patients with Stage IV disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Confidence Intervals. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Survival Analysis. Treatment Outcome

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  • (PMID = 12062608.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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15. Cheng SH, Jian JJ, Tsai SY, Yen KL, Chu NM, Chan KY, Tan TD, Cheng JC, Leu SY, Hsieh CY, Huang AT: Long-term survival of nasopharyngeal carcinoma following concomitant radiotherapy and chemotherapy. Int J Radiat Oncol Biol Phys; 2000 Dec 1;48(5):1323-30
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  • [Title] Long-term survival of nasopharyngeal carcinoma following concomitant radiotherapy and chemotherapy.
  • PURPOSE: The purpose of this study is to demonstrate long-term survival of nasopharyngeal carcinoma treated with concomitant chemotherapy and radiotherapy (CCRT) followed by adjuvant chemotherapy.
  • METHODS AND PATIENTS: One hundred and seven patients with Stage III and IV (American Joint Committee on Cancer, AJCC, 1988) nasopharyngeal carcinoma (NPC) were treated with concomitant chemotherapy and radiotherapy (CCRT) followed by adjuvant chemotherapy between April 1990 and December 1997 in Koo Foundation Sun Yat-Sen Cancer Center, Taipei.
  • The dose of radiation was 70 Gray (Gy) given in 35 fractions, 5 fractions per week.
  • Two courses of chemotherapy, consisting of cisplatin and 5-fluorouracil, were delivered simultaneously with radiotherapy in Weeks 1 and 6 and two additional monthly courses were given after radiotherapy.
  • According to the AJCC 1997 staging system, 32 patients had Stage II disease, 44 had Stage III, and 31 had Stage IV disease.
  • The 3-year overall survival for Stage II was 100%, for Stage III it was 92.8%, and for Stage IV, 69.
  • The 3-year disease-free survival for Stage II was 96.9%, for Stage III it was 87.7%, and for Stage IV it was 51.9% (p = 0.0001).
  • CONCLUSION: CCRT and adjuvant chemotherapy is effective in Taiwanese patients with advanced NPC.
  • The prognosis of AJCC 1997 Stage II and III disease is excellent, but, for Stage IV (M0), it is relatively poor.
  • Future strategies of therapy should focus on high-risk AJCC 1997 Stage IV (M0) cohort.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Radiation-Sensitizing Agents / therapeutic use
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Patient Compliance. Radiotherapy Dosage. Survival Rate. Taiwan. Treatment Failure

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2000 Dec 1;48(5):1277-9 [11121623.001]
  • (PMID = 11121629.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Radiation-Sensitizing Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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16. Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, Chua ET, Lee KM, Yang E, Machin D: Phase III randomized trial of radiotherapy versus concurrent chemo-radiotherapy followed by adjuvant chemotherapy in patients with AJCC/UICC (1997) stage 3 and 4 nasopharyngeal cancer of the endemic variety. J Clin Oncol; 2004 Jul 15;22(14_suppl):5500

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase III randomized trial of radiotherapy versus concurrent chemo-radiotherapy followed by adjuvant chemotherapy in patients with AJCC/UICC (1997) stage 3 and 4 nasopharyngeal cancer of the endemic variety.
  • : 5500 Background: Intergroup 00-99 study for Nasopharyngeal Cancer (NPC) showed a benefit of adding chemotherapy to radiotherapy (RT).
  • All had AJCC(1997) Stage 3 or 4 disease as well as WHO Type II or III histology.
  • 45% had Stage III and 54% Stage IV disease.
  • 2 patients were non-compliant in the R arm.
  • In the C arm, 40% had dose reduction / reduced cycles of chemo during the concurrent phase; 31% did not receive any adjuvant chemotherapy; and another 27% had dose reduction / reduced or delayed cycles of chemo.
  • Median survival time for R was 49.9 months, but this has not been reached for those on C. 2-year DFS rates were 62% for R and 76% for C.
  • CONCLUSIONS: This trial confirms the results of Intergroup 0099 and the results are shown to be applicable to the endemic type of NPC.
  • This study also confirms that chemotherapy improves distant control in NPC.

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  • (PMID = 28014208.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Vermorken JB, Remenar E, van Herpen C, Germa Lluch J, Stewart S, Gorlia T, Degardin M, Schollen K, Bernier J: Standard cisplatin/infusional 5-fluorouracil (PF) vs docetaxel (T) plus PF (TPF) as neoadjuvant chemotherapy for nonresectable locally advanced squamous cell carcinoma of the head andneck (LA-SCCHN): a phase III trial of the EORTC Head and Neck Cancer Group (EORTC #24971). J Clin Oncol; 2004 Jul 15;22(14_suppl):5508

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Standard cisplatin/infusional 5-fluorouracil (PF) vs docetaxel (T) plus PF (TPF) as neoadjuvant chemotherapy for nonresectable locally advanced squamous cell carcinoma of the head andneck (LA-SCCHN): a phase III trial of the EORTC Head and Neck Cancer Group (EORTC #24971).
  • : 5508 Background: Data from 5 phase II studies support the notion that T may add to the efficacy of PF in LA-SCCHN (Posner et al.
  • Based on our phase I-II experience with TPF (Schrijvers et al.
  • METHODS: Eligible pts included nonresectable LA-SCCHN (excluding nasopharynx, nasal & paranasal cavities), measurable disease, adequate organ function, WHO performance status (PS) 0-1, age 18-70 yrs, signed informed consent.
  • Treatment arms were: Arm 1 (PF): P 100 mg/m<sup>2</sup> day (d) 1, then F 1000 mg/m<sup>2</sup> CI d1-5 q 21 d; Arm 2 (TPF): T 75 mg/m<sup>2</sup> d1, P 75 mg/m<sup>2</sup> d1, then 5-FU 750 mg/m<sup>2</sup> CI d1-5 q 21 d.
  • Planned treatment included 4 cycles unless progression (PD), unacceptable toxicity or pt refusal.
  • Pt/tumor characteristics (age, sex, PS, primary site, T&N stage) were well balanced.

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  • (PMID = 28014200.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Djedi H, Bouzid K: Capecitabine-based chemotherapy versus primary treatment for patients with advanced stages of undifferentiated nasopharyngeal carcinoma (UCNT): Preliminary results of a phase II study. J Clin Oncol; 2009 May 20;27(15_suppl):e17049

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Capecitabine-based chemotherapy versus primary treatment for patients with advanced stages of undifferentiated nasopharyngeal carcinoma (UCNT): Preliminary results of a phase II study.
  • : e17049 Background: The combination of cisplatin and 5-fluorouracil (5-FU) is considered to be the standard treatment in induction chemotherapy for patients with undifferentiated nasopharyngeal carcinoma (UCNT).
  • The aim of our study is to evaluate overall response and toxicity of this drug as a primary chemotherapy based-regimen for patients with advanced stages of UCNT.
  • One patient was stage IIB, nine patients stage III, 17 patients stage IVA, five patients stage IVB, and two patients stage IVC.
  • All patients received at least 3 to 4 courses of neoadjuvant chemotherapy.
  • The treatment plan included cisplatin at dose of 75 mg/m2 on D1 every 21 days, followed by capecitabine at a dose of 1,000 mg/m2 twice daily from D2 to D 15, with a 1-week rest period.
  • A CT scan was done at the end of treatment before radiotherapy.
  • RESULTS: After a total of 114 courses, all patients (34 pts) were evaluable for toxicity and 26 patients were evaluable for response (8 pts have not yet achieved their treatment).
  • A clinical benefit was obtained for all patients since the first cure of chemotherapy.
  • One of the two patients with stage IVC had a complete response on hepatic metastasis after 3 cures.
  • Chemotherapy was interrupted for one patient after only one cure because of the cardiac toxicity.
  • CONCLUSIONS: Capecitabine based chemotherapy is a safety and an effective regimen in patients with UCNT.

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  • (PMID = 27961741.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Karasawa K, Umezawa T, Hanyu N, Kawamura H, Kiguchi Y, Mitsuhashi T, Niibe Y: Hyperfractionated radiation therapy for the treatment of squamous cell carcinoma of the head and neck. J Clin Oncol; 2004 Jul 15;22(14_suppl):5554

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hyperfractionated radiation therapy for the treatment of squamous cell carcinoma of the head and neck.
  • : 5554 Background: Altered fractionation radiation therapy has been thought to improve the local control and survival of the patients with head and neck cancer.
  • Since 1996, we have been conducting a clinical trial of hyperfractionated radiation therapy (HFRT) for the treatment of squamous cell carcinoma of the head and neck (SCCHN).
  • Primary site: Larynx 34 cases, hypopharynx 27 cases, oropharynx 17 cases, oral cavity 5 cases, nasopharynx 4 cases, and maxillary sinus 2 cases.
  • Stage I/II/III/IV(M0) = 11/32/15/31.
  • Chemotherapy was combined in 22 cases.
  • OS and LC of stage I-II and III-IV were, 82.7%, 95.2%, and 54.5%, 53.5%, respectively.
  • As for larynx, OS and LC of overall, stage I-II, and stage III-IV were, 91.2%, 84.2%, 100%, 93.8%, and 50% (2y), 67% (1y), respectively.
  • As for oropharynx, OS and LC of overall, stage I-II, and stage III-IV were, 71.1%, 83.9%, 100% (2y), 100% (2y), and 73.8%, 80%, respectively.
  • As for hypopharynx, OS and LC of overall, stage I-II, and stage III-IV were, 49.9%, 65.3%, 53.6%, 100%, and 48.2%, 42.9%, respectively.
  • Disease-specific survival of stage I-II hypopharyngeal cancer was 100%.
  • CONCLUSIONS: HFRT for SCCHN was promising not only for stage III and IV(advanced) cases but also for stage I and II (early) cases.

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  • (PMID = 28013972.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Adane S, Sadouki M, Mekki F, Bouzid K: Gemcitabine (G) plus cisplatin (C) plus radiotherapy in first-line treatment of locally advanced and metastatic undifferentiated carcinoma of the nasopharyngeal type (UCNT): Preliminary results of a phase II study. J Clin Oncol; 2004 Jul 15;22(14_suppl):5618

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gemcitabine (G) plus cisplatin (C) plus radiotherapy in first-line treatment of locally advanced and metastatic undifferentiated carcinoma of the nasopharyngeal type (UCNT): Preliminary results of a phase II study.
  • : 5618 Background: In our experience, G is efficient (44%) in third-line monotherapy of recurrent metastatic nasopharynx carcinoma after first-line 5-fluorouracil + C and second-line anthracyclines + taxanes (ASCO 2002 abstract #3034).
  • In this prospective, phase II study, we used G + C in neoadjuvant setting before radiotherapy in first-line treatment of patients (pts) with locally advanced and metastatic UCNT.
  • METHODS: Chemonaive pts with histologically (WHO type 3) proven stage III and IV TNM/UICC 1997, and an ECOG performance status (PS) 0-2 received G 1250 mg/m<sup>2</sup> over a 30-minute infusion on days (D) 1 and 8 and C 70 mg/m<sup>2</sup> on D1, every 3 weeks.
  • Four to 6 weeks after the third cycle of induction chemotherapy, curative intent radiotherapy was given on nasopharynx (70-72 Gys) and on cervical nodes (50 Gys).
  • Follow-up was performed 4 weeks after the third cycle by clinical evaluation, CT scan of nasopharynx, and nasofibroscopy with biopsy.
  • Seven pts had stage IVA, 3 pts had stage IVC, and 2 pts had stage III.

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  • (PMID = 28015275.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Fuwa N, Kodaira T, Furutani K, Tatibana H, Toita T, Shikama N, Kano M, Hayasi N, Yuta A: Alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil - A preliminary report of phase II study. J Clin Oncol; 2004 Jul 15;22(14_suppl):5613

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil - A preliminary report of phase II study.
  • : 5613 Background: Nasopharyngeal cancer (NPC) is characterized by a high frequency of distant metastasis and mucositis was a marked problem even when radiotherapy (RT) alone was performed.
  • Considering these characteristics of NPC, alternating chemoradiotherapy (ALT-CRT) may be a useful method of treating NPC because sufficient amount of anti-tumor agents can be administered together with a low frequency of mucositis compared to concurrent chemoradiotherapy (CRT).
  • METHODS: The subjects consisted of 16 patients with stage II, 25 patients with stage III and 26 patients with stage IV .
  • Using 6 MV photon, RT was performed at an exposure of 1.8Gy 5 times a week.
  • That is, a total absorbed dose of 36 Gy was irradiated between the basal of skull and supraclavicular fossa.
  • One course of chemotherapy (CT) consisted of the administration of 5-FUdepends on document reviewat a dose of 800 mg/m<sup>2</sup>/24 h for 5 days (days 1-5) and CDDP at a dose of 50 mg/m<sup>2</sup>/24 h for 2 days (days 6-7), and a total of 3 courses of CT was performed.
  • In these 67 patients, the overall 3-year survival rate was 93%, and the progression free survival rate was 80% (The median follow up times was 33 months).
  • CONCLUSIONS: This method of ALT-CRT yielded higher or at least similar survival rate and lower toxicities than concurrent CRT, and we believed that this method can be used in a controlled clinical trial in the future to compare therapeutic results with those of the Intergroup 0099 Trial No significant financial relationships to disclose.

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  • (PMID = 28015269.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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22. Choi JH, Lim HY, Park JS, Kim HC, Kang S, Oh YT, Chun M, Kim CH: Induction chemotherapy (CTX) followed by concurrent chemoradiotherapy (CRT) in patients (pts) with nasopharyngeal cancer (NPC). J Clin Oncol; 2004 Jul 15;22(14_suppl):5598

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Induction chemotherapy (CTX) followed by concurrent chemoradiotherapy (CRT) in patients (pts) with nasopharyngeal cancer (NPC).
  • : 5598 Background: A randomized trial has demonstrated that concurrent CRT is superior to radiotherapy (RT) alone in advanced NPC (Intergroup 0099, J Clin Oncol 16:1310, 1998).
  • METHODS: Between October 1996 and October 2001, we treated 35 pts with NPC (stage I: 1, II: 12, III: 7, IV: 15) with 1 cycle of induction CTX (5-fluorouracil 1000 mg/m<sup>2</sup> D1-4, cisplatin 20 mg/m<sup>2</sup> D1-4) followed by concurrent CRT starting on day 22.
  • RESULTS: Based on post-treatment imaging, complete response (CR) was achieved in 33 pts (94%), partial response in 1 pt, and one pt demonstrated progressive disease.
  • Furthermore, thirty-one patients (89%) experienced at least one type of otototoxicity: otitis media (27 pts), sensorineural and/or conductive hearing loss (21 pts), external otitis (7 pts), tinnitus (5 pts).
  • CONCLUSIONS: The outcome of pts treated with this combined modality therapy appears to be comparable with that of Intergroup 0099 trial with high CR rate.
  • In addition, ototoxicity seems to be a very frequent and clinically significant complication of CRT for NPC.

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  • (PMID = 28014052.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Yamouni M, Beldjillali Y, Benhadji KA, Lahfa I, Brahimi M, Ait-Said M, Djellali L, Bouzid K: A phase II trial of docetaxel and cisplatin combination in patients with locally advanced undifferentiated carcinoma of nasopharygeal type (UCNT). J Clin Oncol; 2004 Jul 15;22(14_suppl):5599

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A phase II trial of docetaxel and cisplatin combination in patients with locally advanced undifferentiated carcinoma of nasopharygeal type (UCNT).
  • : 5599 Background: The standard treatment of locally advanced UCNT is chemotherapy followed by locoregional radiotherapy.
  • The purpose of this study is to assess the antitumor activity and toxicity of a new neoadjuvant chemotherapy regimen combining docetaxel (D) and cisplatin (C).
  • PATIENTS AND METHODS: Previously untreated patients (pts) with histologically diagnosed locally advanced UCNT (Stages IVA and IVB TNM/UICC 1997) received D 75 mg/m<sup>2</sup> and C 75 mg/m<sup>2</sup> both on day 1, cycles were repeated every 21 days.
  • Pts were evaluated by clinical examination, nasofibroscopy with biopsy and CT scan of nasopharynx.
  • 19 pts had stage IVA and 56 pts had stage IVB.
  • The complete response after chemotherapy appear as an important factor predicting recurrence.

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  • (PMID = 28014049.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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24. Poon D, Chowbay B, Leong SS, Cheung YB, Toh CK, Tay MH, Lim WT, Tan EH: Phase II study of irinotecan (CPT-11) as salvage therapy for advanced nasopharyngeal carcinoma (NPC). J Clin Oncol; 2004 Jul 15;22(14_suppl):5576

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II study of irinotecan (CPT-11) as salvage therapy for advanced nasopharyngeal carcinoma (NPC).
  • : 5576 Background: Advanced NPC is chemosensitive and responsive even to third-line salvage regimen, therefore the continued search for active agents to enhance salvage potential.
  • Topoisomerase I targeters have been shown to induce apoptosis in NPC cell lines in in-vitro experiments.
  • This phase II study was designed to evaluate efficacy and safety of irinotecan in patients with advanced NPC.
  • METHODS: Eligibility criteria included AJCC stage IVC nasopharyngeal undifferentiated carcinoma, ECOG performance status (PS) 0-2, progressive disease during or less than 3 months after platinum-based and/or taxane-based regimen, and bidimensionally measurable disease.
  • Irinotecan at 100 mg/m<sup>2</sup> was administered on days 1, 8, 15, every 28 days up to maximum of 6 cycles, or until disease progression or appearance of non-tolerable toxicity.
  • Patient characteristics included mean age 50.9 (standard deviation - SD 7.5), 21 males; 4 females, 23 (92%) are Chinese, 22 (88%) had ECOG PS 0-1, and a mean 2.0 (SD 1.8) prior lines of chemotherapy.
  • CONCLUSIONS: Preliminary results from this trial suggest that irinotecan is an active agent as salvage treatment with modest toxicity in patients with advanced NPC refractory to platinum/taxane-based chemotherapy.

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  • (PMID = 28014014.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Yamouni M, Benhadji KA, Beldjilali Y, Lahfa I, Khellafi H, Abdelaoui A, Djellali L, Bouzid K: Phase II trial of combination docetaxel and cisplatin in patients with locally advanced nasopharyngeal carcinoma. J Clin Oncol; 2009 May 20;27(15_suppl):6044

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II trial of combination docetaxel and cisplatin in patients with locally advanced nasopharyngeal carcinoma.
  • : 6044 Background: The standard treatment of locally advanced nasopharyngeal carcinoma is cisplatin-based chemotherapy followed by locoregional radiotherapy.
  • The purpose of this study is to assess the antitumor activity and toxicity of a new neoadjuvant chemotherapy regimen combining docetaxel (D) and cisplatin (C).
  • METHODS: Previously untreated patients (pts) with histologically diagnosed locally advanced nasopharyngeal carcinoma (stages IVA and IVB, TNM/UICC 1997) received D 75 mg/m<sup>2</sup> and C 75 mg/m<sup>2</sup> both on day 1, with cycles repeated every 21 days.
  • All pts received three cycles in a neoadjuvant setting before radiotherapy (4 to 6 weeks after the third cycle of DC, 65-70 Gy 5 fractions/week).
  • Pts were evaluated by clinical examination, CT scan of the nasopharynx, and nasofibroscopy with biopsy.
  • 75 pts (81%) had an undifferentiated carcinoma of nasopharyngeal type (UCNT) and 18 pts (19%) a differenciated carcinoma of the nasopharynx.
  • 31 pts had stage IVA disease and 62 pts had stage IVB.
  • CONCLUSIONS: DC chemotherapy followed by radiation therapy is an effective regimen for the treatment of advanced UCNT and has an acceptable safety profile.

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  • (PMID = 27961920.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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26. Beldjilali Y, Benhadji KA, Boukerche A, Khellafi H, Abdelaoui A, Betkaoui F, Tourabi ZK, Kaïd MY, Djellali L, Yamouni M: First results of induction chemotherapy with cisplatin, docetaxel, and capecitabine for the treatment of nasopharyngeal carcinoma. J Clin Oncol; 2009 May 20;27(15_suppl):6045

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] First results of induction chemotherapy with cisplatin, docetaxel, and capecitabine for the treatment of nasopharyngeal carcinoma.
  • : 6045 Background: The purpose of this phase II study is to assess a new induction chemotherapy regimen combining cisplatin (P), docetaxel (T), and capecitabine (X) in advanced nasopharyngeal carcinoma.
  • METHODS: Previously untreated patients (pts) with histological diagnosed locally advanced nasopharyngeal carcinoma (stages III, IVA, and IVB UICC 2002) received induction chemotherapy associating P 75 mg/m<sup>2</sup>, T 75 mg/m<sup>2</sup>, both on day 1 and X 1,000 mg/m<sup>2</sup>/d days 1-14.
  • Induction chemotherapy was followed by concurrent chemo-radiotherapy: P 75 mg/m<sup>2</sup> days 1, 22, 42 and radiotherapy (65-70 Gy) 4 to 6 weeks after the fourth cycle of induction treatment.
  • Pts were evaluated according to RECIST criteria by clinical examination and CT scan of the nasopharynx.
  • 30 pts (75%) had an undifferentiated carcinoma of nasopharyngeal type (UCNT) and 10 pts (25%) a poorly differentiated nasopharyngeal carcinoma.
  • 5 pts had stage III disease, 20 pts stage IVA disease and 15 pts stage IVB.
  • CONCLUSIONS: PTX induction chemotherapy resulted on a high response rate with manageable toxicity.
  • Outcome of patients after chemoradiotherapy is awaited to evaluate the effectiveness of this new treatment modality.

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  • (PMID = 27961921.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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27. Bossi P, Parolini D, Bergamini C, Locati LD, Orlandi E, Franceschini M, Palazzi M, Olmi P, Potepan P, Licitra L: TPF induction chemotherapy (CT) followed by concomitant cisplatin/radiotherapy (cCTRT) in locally advanced nasopharyngeal cancer (LANPC). J Clin Oncol; 2009 May 20;27(15_suppl):6046

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] TPF induction chemotherapy (CT) followed by concomitant cisplatin/radiotherapy (cCTRT) in locally advanced nasopharyngeal cancer (LANPC).
  • In head and neck cancer, docetaxel, cisplatin and 5 FU (TPF) induction chemotherapy led to survival gain over cisplatin and 5FU alone.
  • METHODS: From October 2004 to May 2008, 45 pts with LANPC were treated at our Institution with 2 to 4 cycles (median 3) of induction TPF (docetaxel 75 mg/sm and cisplatin 75 mg/sm on day 1, and 5-FU 750 mg/sm/day ci for 96 hrs.
  • All but two pts had non-keratinizing carcinoma.
  • Stage IV pts were 60%, stage III 34%, and 6% stage II.
  • RT dose ranged from 64 Gy to 70 Gy (median 70 Gy).
  • After treatment completion, complete and partial response were recorded in 78% and 20% of the pts respectively, while 1 pt showed stable disease.
  • With a median follow up of 22 months (range 7 to 47), 9 pts showed recurrence or progressive disease (7 at local and/or regional level, 2 distant metastases and 1 at both sites), with a 2-years event free survival of 78% and an overall survival of 85%.
  • In this high-stage nonendemic population local-regional disease control still remains the main therapeutic goal.

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  • (PMID = 27961922.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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28. Tombolini V, De Sanctis V, Donato V, Osti MF, Raffetto N, Santarelli M, Domenico V, De Nicolo M, Enrici RM: Prognostic features and treatment outcome in patients with nasopharyngeal carcinoma: an experience of 20 years. Anticancer Res; 2001 Mar-Apr;21(2B):1413-8
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  • [Title] Prognostic features and treatment outcome in patients with nasopharyngeal carcinoma: an experience of 20 years.
  • BACKGROUND: The best treatment of Nasopharyngeal Carcinoma (NPC) is still an open question.
  • The purpose of this retrospective study was to determine risk factors that affect locoregional control and treatment outcome of NPC patients after radiotherapy, with or without chemotherapy.
  • METHODS: Between January 1976 and December 1996, 66 consecutive patients (stage I = 0; stage II = 13; stage III = 32; stage IV = 21) were given definitive radiotherapy at a single Institution.
  • Concurrent or adjuvant chemotherapy was also given to 14 of them (21%).
  • Multivariate analysis was performed to evaluate age, T stage, N stage, radiotherapy dose, histology, chemotherapy bone of skull erosions or cranial nerve palsies and base of skull involvement as prognostic factors of locoregional control and overall survival.
  • Risk factor analysis revealed that radiotherapy dose, age and stage were the most important factors for overall survival of these patients.
  • The 5 year overall survival was 89% for stage II and 49% for stage III-IV (p = 0.004), 62% for dose higher than 60 Gy and 20% for dose below 60 Gy (p = 0.007), 62% for age below 65 years and 36% for age higher than 65 years (p = 0.027).
  • The concurrent or adjuvant chemotherapy did not have prognostic significance.
  • CONCLUSIONS: We confirm the need to determine the risk factors in patients with NPC.
  • The choice of treatment, whether radiotherapy alone, at dose > 60 Gy, or radiotherapy plus chemotherapy, should be made after identification of patients with high risk disease, suitable for the combined modality.
  • [MeSH-major] Nasopharyngeal Neoplasms / mortality
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Bone Neoplasms / secondary. Dose-Response Relationship, Radiation. Female. Follow-Up Studies. Humans. Lung Neoplasms / secondary. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiation Dosage. Retrospective Studies. Risk Factors. Survival Rate. Treatment Outcome

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  • (PMID = 11396224.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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29. Cheng SH, Yen KL, Jian JJ, Tsai SY, Chu NM, Leu SY, Chan KY, Tan TD, Cheng JC, Hsieh CY, Huang AT: Examining prognostic factors and patterns of failure in nasopharyngeal carcinoma following concomitant radiotherapy and chemotherapy: impact on future clinical trials. Int J Radiat Oncol Biol Phys; 2001 Jul 1;50(3):717-26
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Examining prognostic factors and patterns of failure in nasopharyngeal carcinoma following concomitant radiotherapy and chemotherapy: impact on future clinical trials.
  • PURPOSE: Concomitant chemotherapy and radiotherapy (CCRT), followed by adjuvant chemotherapy, has improved the outcome of nasopharyngeal carcinoma (NPC).
  • However, the prognosis and patterns of failure after this combined-modality treatment are not yet clear.
  • METHODS AND PATIENTS: One hundred forty-nine (149) patients with newly diagnosed and histologically proven NPC were prospectively treated with CCRT followed by adjuvant chemotherapy between April 1990 and December 1997.
  • One hundred and thirty-three (89.3%) patients had MRI of head and neck for primary evaluation before treatment.
  • Radiotherapy was delivered either at 2 Gy per fraction per day up to 70 Gy or 1.2 Gy per fraction, 2 fractions per day, up to 74.4 Gy.
  • Chemotherapy consisted of cisplatin and 5-fluorouracil.
  • According to the AJCC 1997 staging system, 32 patients were in Stage II, 53 in Stage III, and 64 in Stage IV (M0).
  • RESULTS: Univariate analysis revealed that WHO (World Health Organization) Type II histology, T4 classification, and parapharyngeal extension were poor prognostic factors for locoregional control.
  • Univariate analysis for distant metastasis revealed that T4 and N3 classifications, serum LDH level > 410 U/L (normal range, 180-460), parapharyngeal extension, and infiltration of the clivus were significantly associated with poor prognosis.
  • They consisted of Stage II patients with T2aN0, T1N1, and T2aN1 categories and of Stage III patients with T1N2 and T2aN2 categories.
  • They are Stage II patients with T2bN0 and T2bN1 categories and Stage III patients with T2bN2 and T3N0-2 categories.
  • They are stage T4 or N3 patients.
  • Future trials should focus on reducing treatment-associated toxicities and complications and reevaluate the benefit of sequential adjuvant chemotherapy.
  • The recurrence in treatment of intermediate-risk patients is modest; CCRT and adjuvant chemotherapy may be the best standard for them.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Disease-Free Survival. Dose Fractionation. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Forecasting. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Proportional Hazards Models. Prospective Studies. Radiotherapy / adverse effects. Risk Factors. Treatment Outcome

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2002 Mar 15;52(4):1144; author reply 1144-5 [11958916.001]
  • (PMID = 11395240.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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30. Chang YC, Chen SY, Lui LT, Wang TG, Wang TC, Hsiao TY, Li YW, Lien IN: Dysphagia in patients with nasopharyngeal cancer after radiation therapy: a videofluoroscopic swallowing study. Dysphagia; 2003;18(2):135-43
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  • [Title] Dysphagia in patients with nasopharyngeal cancer after radiation therapy: a videofluoroscopic swallowing study.
  • This study evaluated swallowing status and the factors influencing swallowing in patients with nasopharyngeal carcinoma (NPC) after radiation therapy.
  • During the period from July 1995 to June 1999, this cross-sectional study used videofluoroscopic swallowing study (VFSS) to evaluate 184 NPC patients who had completed radiation therapy [113 cases had completed radiation therapy < or = 12 months prior to evaluation (acute group) and 71 cases had completed radiation therapy > 12 months prior to evaluation (chronic group)].
  • The numbers of patients with tumors in each of the four stages were as follows: 24 in stage I, 45 in stage II, 41 in stage III, and 74 in stage IV.
  • Swallowing abnormalities of the acute and chronic groups were correlated with multiple variables, including gender, age, the stage of the tumor, use of either neoadjuvant chemotherapy or radiosensitizer, and radiation modality.
  • Radiation modality, chemotherapy, and tumor staging were not significantly associated with swallowing dysfunction.
  • These findings indicate that swallowing function continues to deteriorate over time, even many years after radiation therapy in patients with NPC.
  • Our results indicate that the time elapsed since radiation therapy correlates with the severity of dysphagia in NPC patients.
  • [MeSH-major] Carcinoma / diagnostic imaging. Carcinoma / radiotherapy. Deglutition Disorders / diagnostic imaging. Deglutition Disorders / etiology. Fluoroscopy. Nasopharyngeal Neoplasms / diagnostic imaging. Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy / adverse effects. Video Recording

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  • [Cites] Int J Radiat Oncol Biol Phys. 1999 Aug 1;45(1):47-52 [10477005.001]
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  • (PMID = 12825907.001).
  • [ISSN] 0179-051X
  • [Journal-full-title] Dysphagia
  • [ISO-abbreviation] Dysphagia
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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31. Fuwa N, Shikama N, Hayashi N, Matsuzuka T, Toita T, Yuta A, Oonishi H, Kodaira T, Tachibana H, Nakamura T, Daimon T: Treatment results of alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil--a phase II study. Oral Oncol; 2007 Oct;43(9):948-55
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  • [Title] Treatment results of alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil--a phase II study.
  • The present study was conducted to evaluate the therapeutic results of alternating chemoradiotherapy for locally advanced nasopharyngeal cancer.
  • The subjects were 87 patients with stage II-IVB nasopharyngeal cancer.
  • Alternating chemoradiotherapy was performed; initially, chemotherapy was administered, and then radiotherapy (wide field), chemotherapy, radiotherapy (shrinking field), and chemotherapy were alternately performed.
  • For chemotherapy, 5-FU at a dose of 800 mg/m2/24 h was intravenously administered for 5 days (days 1-5), and CDDP at a dose of 50 mg/m2/24h for 2 days was administered on day 6 and 7.
  • Although 1 patient developed a transient neurological disturbance induced by hyper-ammonemia by metabolism of 5-FU, no severe adverse effects were noted in any other patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Cisplatin / administration & dosage. Disease-Free Survival. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Radiotherapy Dosage. Radiotherapy, Adjuvant. Remission Induction. Survival Rate

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  • (PMID = 17257880.001).
  • [ISSN] 1368-8375
  • [Journal-full-title] Oral oncology
  • [ISO-abbreviation] Oral Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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32. Chua DT, Wei WI, Sham JS, Cheng AC, Au G: Treatment outcome for synchronous locoregional failures of nasopharyngeal carcinoma. Head Neck; 2003 Jul;25(7):585-94
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment outcome for synchronous locoregional failures of nasopharyngeal carcinoma.
  • BACKGROUND: To review the outcome and evaluate the prognostic factors in the treatment of synchronous locoregional failures of nasopharyngeal carcinoma (NPC).
  • METHODS: We reviewed the records of 43 patients with synchronous locoregional failures of NPC who received salvage treatment or chemotherapy between November 1986 and January 2001.
  • The recurrent disease was stage II in 61%, stage III in 30%, and stage IV in 9%.
  • Seventeen patients received surgery for regional and/or local failures with or without combined radiotherapy (ST group), 14 patients received reirradiation to both local and regional disease (RT group), and 12 patients received palliative chemotherapy only (CT group).
  • RESULTS: The 3-year relapse-free survival (RFS) rate and disease-specific survival (DSS) rate after salvage treatment or chemotherapy were 17% and 38%, respectively.
  • The 3-year RFS rates in stage II, III, and IV disease were 25%, 8%, and 0%, respectively.
  • On multivariate analysis, treatment by reirradiation or chemotherapy alone and rN2 disease were independent factors that predicted poor survival, whereas treatment by reirradiation or chemotherapy alone was the only independent factor that predicted further relapse or failure.
  • CONCLUSIONS: Proper selection of patients for aggressive salvage treatment and individualization of treatment are important in managing patients with synchronous locoregional failures of NPC.
  • A significant proportion of patients with early stage locoregional failures can still achieve long-term disease control and survival after aggressive salvage treatment using surgery with or without combined radiotherapy.
  • In patients with more advanced disease, treatment by reirradiation alone or palliative chemotherapy is largely ineffective and is associated with a poor outcome.
  • [MeSH-major] Carcinoma / pathology. Carcinoma / therapy. Nasopharyngeal Neoplasms / pathology. Nasopharyngeal Neoplasms / therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neck Dissection. Neoplasm Metastasis. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Salvage Therapy. Survival Analysis. Time Factors. Treatment Outcome

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  • [Copyright] Copyright 2003 Wiley Periodicals, Inc. Head Neck 25: 585-594, 2003
  • (PMID = 12808662.001).
  • [ISSN] 1043-3074
  • [Journal-full-title] Head & neck
  • [ISO-abbreviation] Head Neck
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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33. Arakawa K, Shikama N, Sasaki S, Shinoda A, Nishikawa A, Koiwai K, Hirase Y, Okazaki Y, Oguchi M, Kadoya M: [Impact of treatment extending to 60 Gy on the outcome of radiotherapy for nasopharyngeal carcinoma]. Nihon Igaku Hoshasen Gakkai Zasshi; 2003 Jan;63(1):41-6
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  • [Title] [Impact of treatment extending to 60 Gy on the outcome of radiotherapy for nasopharyngeal carcinoma].
  • PURPOSE: To clarify the impact of treatment duration on the outcome of nasopharyngeal carcinoma (NPC).
  • MATERIALS AND METHODS: Forty-three patients with NPC were treated with definitive radiotherapy from January 1980 through May 1996.
  • According to the fifth UICC classification, 4 patients were stage I, 12 were stage II, 6 were stage III, and 21 were stage IV.
  • Twenty-nine patients received chemotherapy.
  • Thus, treatment duration was defined as the duration from the start of radiotherapy to the end of 60 Gy.
  • The 5-year disease-free survival rates of the patients treated with the short treatment duration (< or = 8 weeks) and those treated with the long treatment duration (> 8 weeks) were 76% and 38%, respectively (p = 0.008).
  • CONCLUSION: Long treatment duration may lead to poor treatment outcome in NPC.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Disease-Free Survival. Female. Humans. Male. Middle Aged. Radiotherapy Dosage. Treatment Outcome

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  • (PMID = 12645122.001).
  • [ISSN] 0048-0428
  • [Journal-full-title] Nihon Igaku Hōshasen Gakkai zasshi. Nippon acta radiologica
  • [ISO-abbreviation] Nihon Igaku Hoshasen Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
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34. Feng AC, Wu MC, Tsai SY, Chan KY, Cheng SH, Wang A, Chen SS, Jian JJ, Terng SD, Huang AT: Prevertebral muscle involvement in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2006 Jul 15;65(4):1026-35
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  • [Title] Prevertebral muscle involvement in nasopharyngeal carcinoma.
  • PURPOSE: The purpose of this study is to evaluate the prevalence and prognostic significance of prevertebral muscle involvement in patients with nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: Between July 1990 and December 2001, 521 newly diagnosed patients with NPC treated at Koo Foundation Sun Yat-Sen Cancer Center (KF-SYSCC) were examined with magnetic resonance imaging (MRI) for evidence of prevertebral muscle involvement before treatment.
  • Patients were staged according to the 1997 American Joint Committee on Cancer staging classification of NPC based on the physical exams and MRI findings.
  • All patients received radiotherapy with or without chemotherapy.
  • RESULTS: Of 521 patients treated at KF-SYSCC, 181 (35%) patients were found to have prevertebral muscle involvement, one-third in those with Stage II/III tumors and two-thirds in those with Stage IV tumor.
  • CONCLUSIONS: Prevertebral muscle involvement is an independent prognostic factor for NPC recurrence.
  • [MeSH-major] Muscle Neoplasms / pathology. Muscle, Skeletal / pathology. Nasopharyngeal Neoplasms / pathology

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  • (PMID = 16682150.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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35. Demizu Y, Sasaki R, Soejima T, Maruta T, Okamoto Y, Yamada K, Yoden E, Ejima Y, Ota Y, Ishida H, Nibu K, Sugimura K: Efficacy and feasibility of cisplatin-based concurrent chemoradiotherapy for nasopharyngeal carcinoma. Jpn J Clin Oncol; 2006 Oct;36(10):620-5
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  • [Title] Efficacy and feasibility of cisplatin-based concurrent chemoradiotherapy for nasopharyngeal carcinoma.
  • OBJECTIVE: To investigate the efficacy and feasibility of a cisplatin-based concurrent chemoradiotherapy (CRT) protocol based on Intergroup Study 0099 for nasopharyngeal carcinoma (NPC).
  • METHODS: Sixteen patients with stage II-IVB NPC were treated with a protocol of cisplatin-based concurrent CRT and adjuvant chemotherapy from 1998 to 2002.
  • Three courses of cisplatin (80 mg/m2) were scheduled during 70 Gy of radiotherapy (RT), and two agents of adjuvant chemotherapy (FP regimen: cisplatin 80 mg/m2 and 5-fluorouracil 800 mg/m2/day by 4-day continuous infusion) were challenged.
  • Proportions of patients who tolerated each scheduled treatment were 94% for RT, 63% for concurrent chemotherapy and 38% for adjuvant chemotherapy.
  • CONCLUSIONS: Our protocol of the cisplatin-based concurrent CRT followed by adjuvant chemotherapy consisting of FP regimen was effective for Japanese patients with NPC.
  • However, the doses and numbers of cycle of chemotherapy need to be modified because of the low compliance rate.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Anemia / chemically induced. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Deglutition Disorders. Drug Administration Schedule. Feasibility Studies. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Neutropenia / chemically induced. Radiotherapy Dosage. Survival Rate

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  • (PMID = 16905756.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; CF regimen
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36. Plaza G, Fogué L, Martínez San Millán J, Martínez Vidal A, Bellas C: [Diagnostic evaluation of nasopharyngeal carcinoma: role of Epstein-Barr virus]. An Otorrinolaringol Ibero Am; 2002;29(1):71-91
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  • [Title] [Diagnostic evaluation of nasopharyngeal carcinoma: role of Epstein-Barr virus].
  • [Transliterated title] Evaluación diagnóstica del carcinoma nasofaríngeo: papel del virus de Epstein-Barr.
  • We present a retrospective series of 27 nasopharyngeal carcinomas, selected from those attended at Ramón y Cajal Hospital between 1977 and 1996, with the aim of review the role of the study of Epstein-Barr virus in the diagnostic process of nasopharyngeal carcinoma.
  • Only 8 cases (23%) did not exhibit neck nodes at the moment of diagnosis.
  • CT and MRI were essential to establish staging: 5 stage I, 7 stage II and 15 stage IV, due to regional extension and/or bone erosion.
  • Radiotherapy was employed in all cases, helped by chemotherapy in 20% of them.
  • Of 27 cases of nasopharyngeal carcinoma 4 were differentiated (type I), 2 moderately differentiated (type II) and 22 undifferentiated (type III).
  • Thus, all nasopharyngeal carcinomas were related to Epstein-Barr virus.
  • Expression of LMP-1 seemed to worse the prognosis of nasopharyngeal carcinoma.
  • [MeSH-major] Carcinoma. Nasopharyngeal Neoplasms

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  • (PMID = 11962004.001).
  • [ISSN] 0303-8874
  • [Journal-full-title] Anales otorrinolaringológicos ibero-americanos
  • [ISO-abbreviation] An Otorrinolaringol Ibero Am
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 60
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37. Jereczek-Fossa BA, Morra A, DeBraud F, Alterio D, Mazzetta C, Rocca A, Catalano G, Bianchi L, Pasetti M, Chiesa F, Bruschini R, Orecchia R: Hyperfractionated radiotherapy in locally advanced nasopharyngeal cancer. An analysis of 43 consecutive patients. Strahlenther Onkol; 2004 Jul;180(7):425-33
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  • [Title] Hyperfractionated radiotherapy in locally advanced nasopharyngeal cancer. An analysis of 43 consecutive patients.
  • BACKGROUND: Despite numerous randomized trials suggesting a benefit of unconventional fractionation in locally advanced head and neck cancer, the role of this approach in nasopharyngeal carcinoma is debatable.
  • Based on the current clinical experience, the authors introduced hyperfractionated irradiation in the treatment of locally advanced head and neck cancer, including nasopharyngeal tumors.
  • The preliminary results of this treatment approach in nasopharyngeal cancer patients are presented, with special focus on the pattern of failure and toxicity.
  • PATIENTS AND METHODS: 43 patients with nasopharyngeal cancer (stage II-IV, TNM 1997) underwent hyperfractionated irradiation.
  • In 34 cases, radiotherapy was preceded by a median of three cycles of cisplatin-based induction chemotherapy.
  • Irradiation was delivered using a shrinking-field technique up to a total dose of 74.4 Gy in 62 fractions of 1.2 Gy twice daily (minimum 6-h interval)/5 days/week.
  • 30 of 34 patients (88%) responded to induction chemotherapy.
  • After a median follow-up of 32 months, 18 patients (41%) developed progressive disease.
  • The 2-year progression-free survival and overall survival rates were 58% and 84%, respectively.
  • CONCLUSION: Hyperfractionated radiotherapy seems a feasible and active regimen in locally advanced nasopharyngeal carcinoma.
  • This regimen is associated with a high local control rate; relatively high nodal and distant failure, however, call for further treatment modifications, e. g., optimization of irradiation technique and/or dose escalation as well as improved systemic therapies.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy / methods

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  • (PMID = 15241530.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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38. Koiwai K, Shikama N, Sasaki S, Shinoda A, Kadoya M: Risk factors for severe Dysphagia after concurrent chemoradiotherapy for head and neck cancers. Jpn J Clin Oncol; 2009 Jul;39(7):413-7
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  • METHODS: Forty-seven patients with head and neck cancers who underwent definitive chemoradiotherapy from December 1998 to March 2006 were reviewed retrospectively.
  • The locations of the primary lesion were as follows: larynx in 18 patients, oropharynx in 11, nasopharynx in 7, hypopharynx in 7 and others in 4.
  • Clinical stages were as follows: Stage II in 20 and Stages III-IV in 27.
  • The median cumulative dose of cisplatin was 100 mg/m(2) (range, 80-300) and median radiation dose was 70 Gy (range, 50-70).
  • In univariate analysis, clinical stage (III-IV) (P = 0.017), primary site (oro-hypopharynx) (P = 0.041) and radiation portal size (>11 cm) (P < 0.001) were found to be associated with severe dysphagia.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Deglutition Disorders / etiology. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / radiotherapy. Radiotherapy, Conformal / adverse effects
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / secondary. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Retrospective Studies. Risk Factors. Survival Rate. Treatment Outcome. Young Adult

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  • (PMID = 19383615.001).
  • [ISSN] 1465-3621
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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39. Wolden SL, Zelefsky MJ, Kraus DH, Rosenzweig KE, Chong LM, Shaha AR, Zhang H, Harrison LB, Shah JP, Pfister DG: Accelerated concomitant boost radiotherapy and chemotherapy for advanced nasopharyngeal carcinoma. J Clin Oncol; 2001 Feb 15;19(4):1105-10
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  • [Title] Accelerated concomitant boost radiotherapy and chemotherapy for advanced nasopharyngeal carcinoma.
  • PURPOSE: To evaluate the feasibility and efficacy of concomitant boost radiotherapy (RT) plus cisplatin-based chemotherapy compared with standard fractionation RT for patients with advanced nasopharyngeal cancer.
  • PATIENTS AND METHODS: From 1988 through 1999, 50 patients with American Joint Committee on Cancer stage II-IVb nasopharyngeal carcinoma were treated with 70-Gy concomitant boost RT (1.8 Gy/d, weeks 1 through 6; 1.6 Gy second daily fraction, weeks 5 through 6) and two cycles of concurrent cisplatin 100 mg/m(2) days 1 and 22.
  • Thirty-seven patients also received three cycles of cisplatin-based adjuvant chemotherapy.
  • These 50 patients were compared with a nonrandomized cohort of 51 patients with nasopharyngeal cancer treated with 70-Gy standard fractionation RT (1.8 Gy/d) without chemotherapy from 1988 through 1995.
  • The groups were well matched for prognostic factors except stage, for which the concomitant boost RT/chemotherapy group was more advanced (54%, T3-4; 54%, N2-3; 44%, stage IV) compared with the standard RT group (31%, T3-4, P =.03; 22%, N2-3, P <.001; 20%, stage IV, P <.01).
  • RESULTS: With a median follow-up of 42 months (range, 12 to 129 months), the 3-year actuarial local control, progression-free survival, and survival rates were 89% v 74% (P <.01), 66% v 54% (P =.01), and 84% v 71% (P =.04) for the concomitant boost RT/chemotherapy group and the standard RT patients, respectively.
  • Acute grade 3 mucositis was more prevalent with combined therapy, 84% v 43% (P <.001), resulting in a higher rate of temporary gastrostomy tube placement, 46% v 20% (P <.01).
  • CONCLUSION: Concomitant boost RT with cisplatin-based chemotherapy is feasible and improves local-regional control as well as survival for patients with advanced nasopharyngeal cancer compared with standard RT alone.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cisplatin / administration & dosage. Nasopharyngeal Neoplasms / therapy. Radiotherapy Dosage
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Feasibility Studies. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Survival Analysis

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  • (PMID = 11181675.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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40. Lin JC, Wang WY, Liang WM, Chou HY, Jan JS, Jiang RS, Wang JY, Twu CW, Liang KL, Chao J, Shen WC: Long-term prognostic effects of plasma epstein-barr virus DNA by minor groove binder-probe real-time quantitative PCR on nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy. Int J Radiat Oncol Biol Phys; 2007 Aug 1;68(5):1342-8
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  • [Title] Long-term prognostic effects of plasma epstein-barr virus DNA by minor groove binder-probe real-time quantitative PCR on nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy.
  • PURPOSE: To evaluate the long-term prognostic impact of plasma Epstein-Barr virus (EBV) DNA concentration measured by real-time quantitative polymerase chain reaction (RTQ-PCR) in nasopharyngeal carcinoma (NPC) patients receiving concurrent chemoradiotherapy (CCRT).
  • METHODS AND MATERIALS: Epstein-Barr virus DNA was retrospectively measured from stock plasma of 152 biopsy-proven NPC patients with Stage II-IV (M0) disease with a RTQ-PCR using the minor groove binder-probe.
  • After treatment, plasma EBV DNA decreased or remained 0 for all patients and was detectable in 31 patients (20.4%) with a median concentration 0 copy/mL (interquartile range, 0-0).
  • CONCLUSION: Plasma EBV DNA is the most valuable prognostic factor for NPC.
  • More chemotherapy should be considered for patients with persistently detectable EBV DNA after CCRT.
  • [MeSH-major] DNA, Viral / blood. Herpesvirus 4, Human / genetics. Nasopharyngeal Neoplasms / virology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy / methods. Disease-Free Survival. Female. Humans. Male. Middle Aged. Polymerase Chain Reaction / methods. Prognosis. Retrospective Studies

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  • (PMID = 17449194.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Viral
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41. Shen C, Gao Y, Xu T, Wang X, Ying H, Hu C: Carcinoma of the nasopharynx in young patients: a single institution experience. Clin Oncol (R Coll Radiol); 2009 Oct;21(8):617-22
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  • [Title] Carcinoma of the nasopharynx in young patients: a single institution experience.
  • AIMS: Nasopharyngeal carcinoma (NPC) is rare in young patients.
  • MATERIALS AND METHODS: Forty-two NPC patients aged <or=20 years (median age 16 years) represented only 2.3% of all NPC cases treated in our department between 2000 and 2003.
  • Of these patients, 14 were stage II, 21 stage III, and seven stage IV, as diagnosed according to the 1997 American Joint Committee on Cancer (AJCC) staging system.
  • Seventeen patients received radiotherapy alone and 25 had cisplatin-based chemotherapy additionally.
  • The radiation dose to the primary tumour and involved nodes was 64-74 Gy.
  • Patients with N0-1 had a lower distant metastasis rate compared with patients with N2-3, and the TNM stage grouping was found to be a marginally important prognostic factor for disease-free survival.
  • The addition of chemotherapy failed to be of therapeutic value.
  • A high systemic failure remains a major obstacle to cure young NPC patients.
  • [MeSH-major] Carcinoma / therapy. Nasopharyngeal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Child. Disease-Free Survival. Female. Humans. Male. Nasopharynx / pathology. Neoplasm Metastasis. Radiotherapy Dosage. Retrospective Studies. Young Adult

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  • (PMID = 19660923.001).
  • [ISSN] 1433-2981
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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42. Cheng SH, Tsai SY, Yen KL, Jian JJ, Feng AC, Chan KY, Hong CF, Chu NM, Lin YC, Lin CY, Tan TD, Hsieh CY, Chong V, Huang AT: Prognostic significance of parapharyngeal space venous plexus and marrow involvement: potential landmarks of dissemination for stage I-III nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2005 Feb 1;61(2):456-65
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  • [Title] Prognostic significance of parapharyngeal space venous plexus and marrow involvement: potential landmarks of dissemination for stage I-III nasopharyngeal carcinoma.
  • PURPOSE: To determine whether the parapharyngeal space venous plexus and marrow of the skull base bones are anatomic landmarks of the potential routes for the spread of disease for Stage I-III (American Joint Commission on Cancer 1997 staging system) nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: A total of 364 patients with NPC were enrolled in this study.
  • The selection criteria were Stage I-III disease and primary radiotherapy at our hospital between 1990 and 2001.
  • Patients who had undergone inadequate radiotherapy at a dose of <60 Gy and/or preradiotherapy chemotherapy before the imaging evaluation were excluded from the study.
  • RESULTS: Of the 364 patients treated between 1990 and 2001, 163 (44.8%) had low-risk Stage I-III NPC (without parapharyngeal space extension or T3 disease).
  • The 5-year distant metastasis-free survival rate, with and without adjuvant chemotherapy, was 97% and 96%, respectively.
  • The remaining 201 patients had Stage II-III with parapharyngeal space extension or T3 disease.
  • Their 5-year recurrence-free survival rate, with and without adjuvant chemotherapy, was 76.8% and 53.2% (p = 0.01), respectively.
  • CONCLUSION: Our findings suggest that the risk of distant metastasis in Stage I-III NPC patients without parapharyngeal space extension or T3 disease is extremely low.
  • Invasion into the parapharyngeal space venous plexus and marrow of the skull base bones is associated with distant metastasis, and involvement of these anatomic sites is considered a potential route for hematogenous disease spread in patients with Stage I-III NPC.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Metastasis / prevention & control. Neoplasm Staging. Pharynx. Practice Guidelines as Topic. Prognosis. Proportional Hazards Models. Survival Rate. Treatment Failure

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  • (PMID = 15667967.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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43. Lin S, Pan J, Han L, Zhang X, Liao X, Lu JJ: Nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy: report on the 3-year outcome of a prospective series. Int J Radiat Oncol Biol Phys; 2009 Nov 15;75(4):1071-8
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  • [Title] Nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy: report on the 3-year outcome of a prospective series.
  • PURPOSE: To evaluate the efficacy of intensity-modulated radiotherapy (IMRT) using reduced clinical target volumes (CTV) in the treatment of nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: Between August 2003 and December 2006, 323 patients with NPC were treated with IMRT according to this institutional protocol.
  • Presenting stages were Stage II in 63, Stage III in 166, and Stage IVA/B in 94 patients.
  • High-risk CTV encompassed gross tumor volume and entire nasopharyngeal mucosa with a margin.
  • Uninvolved neck nodes were delineated according to the Radiation Therapy Oncology Group (RTOG)/European Organisation for Research and Treatment of Cancer (EORTC) consensus excluding the deep jugular (i.e., lymph nodes in retrostyloid space above C1 vertebra) and submental nodes.
  • Patients with locoregionally advanced diseases also received cisplatin-based chemotherapy.
  • RESULTS: With a median follow-up of 30 months (range, 4-53 months), 12, 6, and 26 patients had developed local, regional, and distant failures, respectively.
  • Multivariate analyses revealed that T-classification had no predictive value for outcome, whereas N-classification was significant for predicting metastasis-free (p = 0.005) and overall survival (p =0.006).
  • Ten patients (7.8%) experienced Grade II xerostomia at 24 months after treatment.
  • Two patients died of treatment-induced complications.
  • CONCLUSION: The IMRT approach using a reduced target volume provided favorable outcome for NPC with acceptable toxicity.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated / methods

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  • (PMID = 19362784.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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44. Fuwa N, Kodaira T, Tachibana H, Nakamura T, Daimon T: Dose escalation study of nedaplatin with 5-fluorouracil in combination with alternating radiotherapy in patients with head and neck cancer. Jpn J Clin Oncol; 2007 Mar;37(3):161-7
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  • [Title] Dose escalation study of nedaplatin with 5-fluorouracil in combination with alternating radiotherapy in patients with head and neck cancer.
  • BACKGROUND: This study, with a large number of patients, confirms that after administration of 5-fluorouracil (5FU), a higher dose of nedaplatin (NDP) can be safely administered rather than a single therapy of NDP, as demonstrated in a phase I study.
  • METHODS: The subjects were 52 patients with stage II-IV (M0) head and neck cancer other than nasopharyngeal cancer.
  • Initially, chemotherapy was administered.
  • For chemotherapy, 5FU at 700 mg/m2/24 h was intravenously administered for 5 days (days 1-5), and NDP was administered on day 6.
  • We established three dose groups: level 1, 120 mg/m2; level 2, 140 mg/m2; and level 3, 150 mg/m2 (n = 13 or more per group).
  • The 5-year overall survival rates were 77% (95% CI: 66-90%) in all subjects and 75% (95% CI: 61-92%) in the stage III/IV patients.
  • The 5-year progression-free survival rates were 73% (95% CI: 62-87%) in all subjects and 72% (95% CI: 57-89%) in the stage III/IV patients.
  • The efficacy of chemotherapy with NDP and 5FU should be compared to that of chemotherapy with CDDP and 5FU.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Squamous Cell / therapy. Head and Neck Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Organoplatinum Compounds / administration & dosage. Survival Rate. Treatment Outcome

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  • (PMID = 17332057.001).
  • [ISSN] 1465-3621
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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45. Ozyar E, Yildz F, Akyol FH, Atahan IL: Adjuvant high-dose-rate brachytherapy after external beam radiotherapy in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2002 Jan 1;52(1):101-8
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  • [Title] Adjuvant high-dose-rate brachytherapy after external beam radiotherapy in nasopharyngeal carcinoma.
  • PURPOSE: To compare the local control and survival rates obtained with either external beam radiation therapy (ERT) and adjuvant high-dose-rate (HDR) brachytherapy (BRT) or ERT alone in patients with nasopharyngeal cancer.
  • METHODS AND MATERIALS: Between December 1993 and December 1999, 144 patients (106 male, 38 female) with the diagnosis of nasopharyngeal cancer were treated with either ERT and adjuvant HDR BRT (Group A) or ERT alone (Group B) at our department.
  • According to the AJCC-1997 staging system, there were 11 (7.6%), 35 (24.3%), 38 (26.4%), and 60 (41.7%) patients in Stage I, II, III, and IV, respectively.
  • Histopathologic diagnosis was WHO 2-3 in 137 (95.2%) patients.
  • ERT doses ranged between 58.8 and 74 Gy (median: 66 Gy).
  • There were significantly more patients with young age, N2 status, and Stage III disease in Group B and with Stage II disease in Group A.
  • Significantly more patients received chemotherapy in Group B.
  • Dose was prescribed at 1 cm from the source, and total dose of 12 Gy in 3 fractions on 3 consecutive days was given immediately after ERT.
  • Besides radiotherapy, 82 (56.9%) patients received cisplatin-based chemotherapy, as well.
  • Follow-up time ranged between 12 and 80 months (median: 32 months).
  • Multivariate analysis showed that advanced nodal status and male gender were significantly unfavorable factors for disease-free survival, and Stage II disease was unfavorable for local recurrence-free survival.
  • Out of 106 patients, 42 (39.7%) experienced nasal congestion, transient nasal obstruction, and/or fibrinous exudate in response to antihistaminic treatment.
  • Five patients developed severe neural complications; only one out of five was observed in Group A.
  • CONCLUSION: The acute and late morbidity of adjuvant HDR BRT is acceptable with our treatment scheme, but we did not find any local control difference between our patients treated with adjuvant BRT after ERT and ERT alone.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy

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  • (PMID = 11777627.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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46. Xie FY, Huang HY, Hu JZ: [Observation on effect of radiotherapy and antike capsule combination therapy in treating nasopharyngeal cancer patients]. Zhongguo Zhong Xi Yi Jie He Za Zhi; 2001 Dec;21(12):888-90
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  • [Title] [Observation on effect of radiotherapy and antike capsule combination therapy in treating nasopharyngeal cancer patients].
  • OBJECTIVE: To compare the effect of radiotherapy (RT) combined with Antike capsule (AC) and RT alone in treating nasopharyngeal cancer (NPC) patients.
  • METHODS: Eighty-nine patients with pathologically confirmed NPC (stage II-IV) were randomly divided into two groups: group A (46 cases) were treated with RT, receiving 65-70 Gy/6.5-7 weeks to nasopharynx region and the same dosage to neck region, and AC was given in combination.
  • The total dosis of RT for complete remission (CR) of primary nasopharyngeal tumor and neck lymph nodes, the CR rate and the changes of peripheral NK cell, T lymphocyte subsets in the two groups were compared.
  • RESULTS: The total dosis of RT for CR in group A and B were 41.6 +/- 8.9 Gy vs 50.7 +/- 9.2 Gy for primary nasopharyngeal tumor, P < 0.05 and 47.4 +/- 10.3 Gy vs 56.2 +/- 9.7 Gy for neck lymph nodes, P < 0.05.
  • The CR rate of primary nasopharyngeal tumor in group A and B were 93.5% and 88.4% respectively, P < 0.05.
  • The activity of NK cell as well as T3, T4 in peripheral blood increased significantly in the group A after treatment, P < 0.05, while in group B, T3, T4 lowered significantly, P < 0.05.
  • CONCLUSION: RT combined with AC could be helpful in elevating and promoting the remission rate of primary tumor and neck lymph nodes, and AC has some effects in improving the immune function and general condition in NPC patients during RT.

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  • (PMID = 12575586.001).
  • [ISSN] 1003-5370
  • [Journal-full-title] Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine
  • [ISO-abbreviation] Zhongguo Zhong Xi Yi Jie He Za Zhi
  • [Language] CHI
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Capsules; 0 / Cobalt Radioisotopes; 0 / Drugs, Chinese Herbal
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47. Hara W, Loo BW Jr, Goffinet DR, Chang SD, Adler JR, Pinto HA, Fee WE, Kaplan MJ, Fischbein NJ, Le QT: Excellent local control with stereotactic radiotherapy boost after external beam radiotherapy in patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2008 Jun 1;71(2):393-400
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  • [Title] Excellent local control with stereotactic radiotherapy boost after external beam radiotherapy in patients with nasopharyngeal carcinoma.
  • PURPOSE: To determine long-term outcomes in patients receiving stereotactic radiotherapy (SRT) as a boost after external beam radiotherapy (EBRT) for locally advanced nasopharyngeal carcinoma (NPC).
  • Sixteen patients had Stage II, 19 had Stage III, and 47 had Stage IV disease.
  • Patients received 66 Gy of EBRT followed by a single-fraction SRT boost of 7-15 Gy, delivered 2-6 weeks after EBRT.
  • Seventy patients also received cisplatin-based chemotherapy delivered concurrently with and adjuvant to radiotherapy.
  • CONCLUSION: Stereotactic radiotherapy boost after EBRT provides excellent local control for patients with NPC.
  • Better systemic therapies for distant control are needed.
  • [MeSH-major] Nasopharyngeal Neoplasms / surgery. Radiosurgery
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Male. Middle Aged. Radiation Injuries / pathology. Radiotherapy Dosage. Temporal Lobe / radiation effects. Treatment Outcome

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  • (PMID = 18164839.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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48. Lee AW, Sze WM, Au JS, Leung SF, Leung TW, Chua DT, Zee BC, Law SC, Teo PM, Tung SY, Kwong DL, Lau WH: Treatment results for nasopharyngeal carcinoma in the modern era: the Hong Kong experience. Int J Radiat Oncol Biol Phys; 2005 Mar 15;61(4):1107-16
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  • [Title] Treatment results for nasopharyngeal carcinoma in the modern era: the Hong Kong experience.
  • PURPOSE: To analyze the treatment results achievable for nasopharyngeal carcinoma in the modern era to identify the key failures for future improvement and to provide an updated baseline for future trials.
  • The stage distribution (by American Joint Committee on Cancer and International Union Against Cancer staging system, 1997) was 7% Stage I, 41% Stage II, 25% Stage III, and 28% Stage IVA-B.
  • All patients were irradiated with 6-MV photons and the median total dose was 66 Gy.
  • Only 23% of patients had additional treatment with chemotherapy.
  • The 5-year progression-free, overall, and cancer-specific survival rates were 63%, 75%, and 80%, respectively.
  • The presenting stage was the most important prognostic factor for all endpoints: with overall survival decreasing from 90% for Stage I to 58% for Stage IVA-B.
  • The results achieved by the 2070 patients treated by radiotherapy alone were almost identical to that of the whole series, the distant failure-free rate among patients with locoregional control was 89% for Stage I-II and 75% for Stage III-IVB.
  • The 860 patients (32%) staged with magnetic resonance imaging achieved significantly better results than those staged by computed tomography, the overall survival being 93% vs. 83% for Stages I-II, and 72% vs. 63% for Stages III-IVB (p = 0.001).
  • CONCLUSIONS: Treatment results for nasopharyngeal carcinoma have substantially improved in the modern era; future trials should be based on updated baseline results.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Hong Kong. Humans. Male. Middle Aged. Radiotherapy Dosage. Retrospective Studies. Survival Rate. Treatment Failure

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  • (PMID = 15752890.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
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49. Oksüz DC, Meral G, Uzel O, Cağatay P, Turkan S: Reirradiation for locally recurrent nasopharyngeal carcinoma: treatment results and prognostic factors. Int J Radiat Oncol Biol Phys; 2004 Oct 1;60(2):388-94
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  • [Title] Reirradiation for locally recurrent nasopharyngeal carcinoma: treatment results and prognostic factors.
  • PURPOSE: To analyze the results and evaluate the prognostic factors in the retreatment of locally recurrent nasopharyngeal carcinoma.
  • METHODS AND MATERIALS: Forty-one patients with locally recurrent nasopharyngeal carcinoma, who were reirradiated between 1979 and 2000, were retrospectively analyzed.
  • Histologically, 9 tumors (22%) were World Health Organization (WHO) I, 17 (41.5%) WHO II, and 15 (36.5%) WHO III.
  • According to the 1998 TNM staging system of the American Joint Committee on Cancer, the recurrent disease was Stage I in 5 (12.2%), Stage II in 11 (26.8%), Stage III in 6 (14.6%), and Stage IV in 19 (46.4%) patients.
  • Treatment was delivered with 4-6 MV X-rays or Co-60 gamma rays.
  • The median reirradiation dose was 50 Gy.
  • Treatment was delivered at 1.8-2 Gy/fraction daily, 5 days a week.
  • Chemotherapy was used in 41.5% of the patients.
  • The 2-year and 5-year local progression-free and overall survival rates were 39%, 23%, 48%, and 28%, respectively.
  • For overall survival age, total reirradiation dose, stage, T stage were significant.
  • On multivariate analysis only total dose (p = 0.005) remained significant for local progression-free rate and total reirradiation dose (p = 0.02), interval to recurrence (p = 0.03), stage (p = 0.018) were significant for overall survival.
  • CONCLUSIONS: Early diagnosis of local recurrence and high-dose reirradiation (60 Gy) are crucial for improving the local control and survival.
  • [MeSH-major] Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy. Neoplasm Recurrence, Local / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Analysis of Variance. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Proportional Hazards Models. Radiation Injuries / etiology. Radiotherapy Dosage. Remission Induction. Retrospective Studies

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  • (PMID = 15380570.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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50. Seung S, Bae J, Solhjem M, Bader S, Gannett D, Hansen EK, Louie J, Underhill K, Cha C: Intensity-modulated radiotherapy for head-and-neck cancer in the community setting. Int J Radiat Oncol Biol Phys; 2008 Nov 15;72(4):1075-81

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  • [Title] Intensity-modulated radiotherapy for head-and-neck cancer in the community setting.
  • PURPOSE: To review outcomes with intensity-modulated radiation therapy (IMRT) in the community setting for the treatment of nasopharyngeal and oropharyngeal cancer.
  • METHODS AND MATERIALS: Between April 2003 and April 2007, 69 patients with histologically confirmed cancer of the nasopharynx and oropharynx underwent IMRT in our practice.
  • The primary sites included nasopharynx (11), base of tongue (18), and tonsil (40).
  • The disease stage distribution was as follows: 2 Stage I, 11 Stage II, 16 Stage III, and 40 Stage IV.
  • The median prescribed doses were 70 Gy to the planning target volume, 59.4 Gy to the high-risk subclinical volume, and 54 Gy to the low-risk subclinical volume.
  • Forty-five patients (65%) received concurrent chemotherapy.
  • Toxicity was graded according to the Radiation Therapy Oncology Group toxicity criteria.
  • [MeSH-major] Community Health Services. Nasopharyngeal Neoplasms / radiotherapy. Oropharyngeal Neoplasms / radiotherapy. Radiodermatitis / etiology. Radiotherapy, Conformal / adverse effects. Radiotherapy, Conformal / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Head and Neck Neoplasms / radiotherapy. Humans. Male. Middle Aged. Oregon. Retrospective Studies. Treatment Outcome

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  • (PMID = 18486355.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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51. Wolden SL, Chen WC, Pfister DG, Kraus DH, Berry SL, Zelefsky MJ: Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience. Int J Radiat Oncol Biol Phys; 2006 Jan 1;64(1):57-62
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  • [Title] Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience.
  • PURPOSE: We previously demonstrated that intensity-modulated radiation therapy (IMRT) significantly improves radiation dose distribution over three-dimensional planning for nasopharynx cancer and reported positive early clinical results.
  • METHODS AND MATERIALS: Since 1998, all 74 patients with newly diagnosed, nonmetastatic nasopharynx cancer were treated with IMRT using accelerated fractionation to 70 Gy; 59 received a hyperfractionated concomitant boost, and more recently 15 received once-daily treatment with dose painting.
  • With the exception of Stage I disease (n = 5) and patient preference (n = 1), 69 patients received concurrent and adjuvant platinum-based chemotherapy similar to that in the Intergroup 0099 trial.
  • RESULTS: median age 45; 32% Asian; 72% male; 65% World Health Organization III; 6% Stage I, 16% Stage II, 30% Stage III, 47% Stage IV.
  • There was 100% local control for Stage T1/T2 disease, compared to 83% for T3/T4 disease (p = 0.01).
  • Six patients failed at the primary site, with median time to local tumor progression 16 months; 5 were exclusively within the 70 Gy volume, and 1 was both within and outside the target volume.
  • There is a trend for improved local control with IMRT when compared to local control of 79% for 35 patients treated before 1998 with three-dimensional planning and chemotherapy (p = 0.11).
  • CONCLUSIONS: The pattern of primary site failure within the target volume suggests locally advanced T stage disease may require a higher biologic dose to gross tumor.
  • Rates of severe (Grade 3-4) ototoxicity and xerostomia are low with IMRT as a result of normal-tissue protection.
  • Distant metastases are now the dominant form of failure, emphasizing the need for improved systemic therapy.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Female. Hearing Loss / etiology. Humans. Male. Middle Aged. Radiotherapy Dosage. Retrospective Studies. Xerostomia / etiology

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  • (PMID = 15936155.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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52. Kam MK, Teo PM, Chau RM, Cheung KY, Choi PH, Kwan WH, Leung SF, Zee B, Chan AT: Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: the Hong Kong experience. Int J Radiat Oncol Biol Phys; 2004 Dec 1;60(5):1440-50
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  • [Title] Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: the Hong Kong experience.
  • PURPOSE: To evaluate the efficacy of using intensity-modulated radiotherapy (IMRT) in the primary treatment of nasopharyngeal carcinoma (NPC), including the role of dose escalation above 66 Gy level.
  • METHODS AND MATERIALS: Between July 2000 and September 2002, 63 newly diagnosed NPC patients were treated with IMRT.
  • The disease was Stage I in 9 (14%), Stage II in 18 (29%), Stage III in 22 (35%), and Stage IV in 14 (22%).
  • The prescribed dose was 66 Gy to the gross tumor volume (GTV) and positive neck nodes, 60 Gy to the planning target volume (PTV), and 54-60 Gy to the clinically negative neck.
  • All 20 (100%) patients with T1-2a tumors received intracavitary brachytherapy (ICB) boost, and 15/42 (36%) patients with T2b-T4 tumors received conformal boost (8 Gy/4 fractions).
  • Nineteen patients with advanced stage disease also received either neoadjuvant or concurrent chemotherapy.
  • Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria.
  • RESULTS: With a median follow-up of 29 months (range 8-45 months), 4 patients developed local in-field failure, 1 patient developed regional relapse, and 13 patients developed distant metastases.
  • All 4 patients with local failure had either T3 or T4 disease before primary treatment and did not have ICB or conformal boost.
  • Multivariate analysis showed that dose escalation above 66 Gy was significantly associated with better PFS and DMFS, whereas GTV size was a significant adverse factor for OS.
  • Within the subset of patients with a mean parotid dose of <31 Gy, the proportions with Grade 2-3 xerostomia were 30% and 17% at 3 months and 2 years, respectively.
  • CONCLUSION: Our experience of using IMRT in the primary treatment of NPC showed a very high rate of locoregional control and favorable toxicity profile.
  • Furthermore, we found that dose escalation above 66 Gy of IMRT-based therapy was a significant determinant of progression-free survival and distant metastasis-free survival for advanced T-stage tumors.
  • Distant metastases represent the predominant mode of treatment failure.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Conformal / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Confidence Intervals. Dose-Response Relationship, Radiation. Female. Follow-Up Studies. Hong Kong. Humans. Male. Middle Aged. Multivariate Analysis. Radiotherapy Dosage. Radiotherapy Planning, Computer-Assisted. Treatment Failure. Xerostomia / etiology

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  • (PMID = 15590175.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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53. Le QT, Tate D, Koong A, Gibbs IC, Chang SD, Adler JR, Pinto HA, Terris DJ, Fee WE, Goffinet DR: Improved local control with stereotactic radiosurgical boost in patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2003 Jul 15;56(4):1046-54
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  • [Title] Improved local control with stereotactic radiosurgical boost in patients with nasopharyngeal carcinoma.
  • PURPOSE: Treatment of nasopharyngeal carcinoma using conventional external beam radiotherapy (EBRT) alone is associated with a significant risk of local recurrence.
  • METHODS AND MATERIALS: Forty-five nasopharyngeal carcinoma patients received a STR boost after EBRT at Stanford University.
  • Seven had T1, 16 had T2, 4 had T3, and 18 had T4 tumors (1997 American Joint Commission on Cancer staging).
  • Ten had Stage II, 8 had Stage III, and 27 had Stage IV neoplasms.
  • Most patients received 66 Gy of EBRT delivered at 2 Gy/fraction.
  • Thirty-six received concurrent cisplatin-based chemotherapy.
  • STR was delivered to the primary site 4-6 weeks after EBRT in one fraction of 7-15 Gy.
  • Univariate and multivariate analyses revealed N stage (favoring N0-N1, p = 0.02, hazard ratio HR 4.2) and World Health Organization histologic type (favoring type III, p = 0.002, HR 13) as significant factors for freedom from distant metastasis.
  • World Health Organization histologic type (p = 0.004, HR 10.5) and age (p = 0.01, HR 1.07/y) were significant factors for survival.
  • CONCLUSION: STR boost after EBRT provided excellent local control in nasopharyngeal carcinoma patients.
  • More effective systemic treatment is needed to achieve improved survival.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Nasopharyngeal Neoplasms / surgery. Radiosurgery / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Dose Fractionation. Female. Humans. Male. Middle Aged. Prognosis. Radiotherapy / adverse effects

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  • (PMID = 12829140.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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54. Ghi MG, Paccagnella A, D'Amanzo P, Mione CA, Fasan S, Paro S, Mastromauro C, Carnuccio R, Turcato G, Gatti C, Pallini A, Nascimben O, Biason R, Oniga F, Medici M, Rossi F, Fila G: Neoadjuvant docetaxel, cisplatin, 5-fluorouracil before concurrent chemoradiotherapy in locally advanced squamous cell carcinoma of the head and neck versus concomitant chemoradiotherapy: a phase II feasibility study. Int J Radiat Oncol Biol Phys; 2004 Jun 1;59(2):481-7
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  • [Title] Neoadjuvant docetaxel, cisplatin, 5-fluorouracil before concurrent chemoradiotherapy in locally advanced squamous cell carcinoma of the head and neck versus concomitant chemoradiotherapy: a phase II feasibility study.
  • PURPOSE: To determine the feasibility of neoadjuvant docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by concurrent chemoradiotherapy (CHT-RT) compared with the same CHT-RT regimen alone in locally advanced head-and-neck squamous cell carcinoma.
  • METHODS AND MATERIALS: We treated 24 patients (20 men and 4 women) who had Stage III-IVM0 squamous cell carcinoma of the oral cavity, oropharynx, nasopharynx, or hypopharynx.
  • The stage distribution was as follows: Stage II, 1 patient; Stage III, 6 patients; and Stage IV, 17; 18 patients had a performance status of 0 and 6 had a performance status of 1.
  • Group 1 underwent three cycles of CHT (carboplatin area under the curve 1.5 on Days 1-4 and 5-fluorouracil 600 mg/m(2)/d continuous infusion for 96 h) starting on Days 1, 22, and 43 during RT (one daily fraction, 66-70 Gy within 33-35 fractions).
  • In Group 3, 25% of the patients developed World Health Organization G3-G4 mucositis.
  • At the end of therapy, the CR rate was 62.5% for CHT-RT alone (Group 1) and 80% for neoadjuvant TPF followed by CHT-RT (Groups 2 and 3).
  • A randomized multicenter Phase III study has been started with the aim of comparing two cycles of PF during RT as standard treatment vs. the experimental arm with three cycles of neoadjuvant TPF followed by two cycles of PF during RT.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Anemia / etiology. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy / adverse effects. Feasibility Studies. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neutropenia / etiology. Radiotherapy Dosage. Stomatitis / etiology. Taxoids / administration & dosage. Thrombocytopenia / etiology

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  • (PMID = 15145166.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Controlled Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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55. Xie FY, Qi SN, Hu WH, Zou GR, Peng M, Li JS: [Comparison of efficacy of docetaxel combined cisplatin (TP regimen) and cisplatin combined 5-fluorouracil (PF regimen) on locally advanced nasopharyngeal carcinoma]. Ai Zheng; 2007 Aug;26(8):880-4
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  • [Title] [Comparison of efficacy of docetaxel combined cisplatin (TP regimen) and cisplatin combined 5-fluorouracil (PF regimen) on locally advanced nasopharyngeal carcinoma].
  • BACKGROUND & OBJECTIVE: Docetaxel and cisplatin (DDP) are effective drugs for head and neck tumors.
  • Stage II-III clinical trial of TP regimen (docetaxel combined DDP) for head and neck tumors has completed.
  • This study was to compare the efficacy and toxicity of TP regimen and PF regimen [DDP combined 5-fluorouracil (5-FU)] in treating nasopharyngeal carcinoma (NPC), to provide a new chemotherapeutic regimen for NPC.
  • METHODS: Twenty NPC patients treated in Cancer Center of Sun Yat-sen University between Oct.
  • Twenty patients were chosen randomly from the 45 NPC patients treated with PF regimen between May 1, 2004 and Sep.
  • RESULTS: The mean number of chemotherapy cycles was significantly higher in TP group than in PF group (3.85 cycles vs. 2.75 cycles, P<0.001).
  • After induction chemotherapy, in TP group, 18 achieved partial remission (PR) and 2 had stable disease (SD) for nasopharyngeal lesions, 7 achieved complete remission (CR), 11 achieved PR and 2 had SD for regional lymph nodes; in PF group, 17 achieved PR and 3 had SD for nasopharyngeal lesions, 2 achieved CR, 15 achieved PR and 1 had SD for regional lymph nodes.
  • After concurrent chemoradiotherapy, all in TP group and 18 in PF group achieved CR for nasopharyngeal lesions, and 19 in TP group and 15 in PF group achieved CR for regional lymph nodes.
  • There was no significant difference in efficacy between the 2 groups (P>0.05).
  • The occurrence rates of grade 3-4 neutropenia were significantly higher in TP group than in PF group (40.5% vs. 0% after induction chemotherapy, 40.5% vs. 10.2% after concurrent radiochemotherapy, P<0.05).
  • The uses of antibiotics and parenteral nutritional support in the 2 groups were similar.
  • CONCLUSION: The efficacy of TP regimen on NPC is similar to that of PF regimen, and the adverse events are tolerable, but the long-term outcomes and toxicities need to be further investigated.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Nasopharyngeal Neoplasms / drug therapy
  • [MeSH-minor] Adult. Anemia / chemically induced. Cisplatin / administration & dosage. Cisplatin / adverse effects. Cisplatin / therapeutic use. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Fluorouracil / therapeutic use. Humans. Leukopenia / chemically induced. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Particle Accelerators. Radiotherapy, High-Energy / adverse effects. Stomatitis / etiology. Taxoids / administration & dosage. Taxoids / adverse effects

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  • (PMID = 17697552.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; CF regimen
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56. Katz TS, Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Villaret DB: Malignant tumors of the nasal cavity and paranasal sinuses. Head Neck; 2002 Sep;24(9):821-9
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  • PURPOSE: To evaluate the role of radiation therapy in patients with nasal cavity and paranasal sinus tumors.
  • MATERIALS AND METHODS: Between October 1964 and July 1998, 78 patients with malignant tumors of the nasal cavity (48 patients), ethmoid sinus (24 patients), sphenoid sinus (5 patients), or frontal sinus (1 patient) were treated with curative intent by radiation therapy alone or in the adjuvant setting.
  • There were 25 squamous cell carcinomas, 14 undifferentiated carcinomas, 31 minor salivary gland tumors (adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma), 8 esthesioneuroblastomas, and 1 transitional cell carcinoma.
  • Forty-seven patients were treated with irradiation alone, 25 with surgery and postoperative irradiation, 2 with preoperative irradiation and surgery, and 4 with chemotherapy in combination with irradiation with or without surgery.
  • RESULTS: The 5-year actuarial local control rate for stage I (limited to the site of origin; 22 patients) was 86%; for stage II (extension to adjacent sites (eg, adjacent sinuses, orbit, pterygomaxillary fossa, nasopharynx; 21 patients) was 65%; and for stage III (destruction of skull base or pterygoid plates, or intracranial extension; 35 patients) was 34%.
  • Of the 67 (86%) patients who were initially seen with node-negative disease, 39 (58%) received no elective neck treatment, and 28 (42%) received elective neck irradiation.
  • Of the 39 patients who received no elective neck treatment, 33 (85%) did not experience recurrence in the neck compared with 25 (89%) of 28 patients who received elective neck irradiation.
  • Most patients who received elective neck irradiation (57%) had stage III disease.
  • CONCLUSION: Surgery and postoperative radiation therapy may result in improved local control, absolute survival, and complications when compared with radiation therapy alone.
  • Elective neck irradiation is probably unnecessary for patients with early-stage disease.
  • [MeSH-major] Carcinoma / therapy. Nasal Cavity. Nose Neoplasms / therapy. Paranasal Sinus Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Blindness / etiology. Blindness / prevention & control. Cause of Death. Chemotherapy, Adjuvant. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Metastasis. Neoplasm Staging. Osteoradionecrosis / etiology. Postoperative Care. Preoperative Care. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Risk Factors. Survival Rate. United States / epidemiology

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  • [Copyright] Copyright 2002 Wiley Periodicals, Inc. Head Neck 24: 821-829, 2002
  • (PMID = 12211046.001).
  • [ISSN] 1043-3074
  • [Journal-full-title] Head & neck
  • [ISO-abbreviation] Head Neck
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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57. Sultanem K, Shu HK, Xia P, Akazawa C, Quivey JM, Verhey LJ, Fu KK: Three-dimensional intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: the University of California-San Francisco experience. Int J Radiat Oncol Biol Phys; 2000 Oct 1;48(3):711-22
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  • [Title] Three-dimensional intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: the University of California-San Francisco experience.
  • PURPOSE: To review our experience with three-dimensional intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma.
  • METHODS AND MATERIALS: We reviewed the records of 35 patients who underwent 3D IMRT for nasopharyngeal carcinoma at the University of California-San Francisco between April 1995 and March 1998.
  • According to the 1997 American Joint Committee on Cancer staging classification, 4 (12%) patients had Stage I disease, 6 (17%) had Stage II, 11 (32%) had Stage III, and 14 (40%) had Stage IV disease.
  • A forward 3D treatment-planning system was used for the first two methods, and an inverse treatment planning system was used for the third method.
  • The prescribed dose was 65-70 Gy to the gross tumor volume (GTV) and positive neck nodes, 60 Gy to the clinical target volume (CTV), and 50-60 Gy to the clinically negative neck.
  • Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria.
  • Only 1 patient had a transient Grade 4 soft-tissue necrosis.
  • At 24 months after treatment, 50% of the evaluated patients had Grade 0, 50% had Grade 1, and none had Grade 2 xerostomia.
  • Analysis of the dose-volume histograms (DVHs) showed that the average maximum, mean, and minimum dose delivered were 79.5 Gy, 75.8 Gy, and 56.5 Gy to the GTV, and 78.9 Gy, 71.2 Gy, and 45.4 Gy to the CTV, respectively.
  • The average dose to 5% of the brain stem, optic chiasm, and right and left optic nerves was 48.3 Gy, 23.9 Gy, 15.0 Gy, and 14.9 Gy, respectively.
  • The average dose to 1 cc of the cervical spinal cord was 41.7 Gy.
  • 2 Gy, 41.0 Gy, 46.3 Gy, 60.5 Gy, 58.3 Gy, 52.0 Gy, and 52.2 Gy, respectively.
  • Local-regional control rate with combined IMRT and chemotherapy was excellent, although distant metastasis remained unabated.
  • [MeSH-major] Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy Planning, Computer-Assisted / methods. Radiotherapy, Conformal / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Disease Progression. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Radiation Injuries / pathology. Radiotherapy Dosage. Survival Analysis. Xerostomia / etiology

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  • (PMID = 11020568.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
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58. Laskar S, Bahl G, Muckaden M, Pai SK, Gupta T, Banavali S, Arora B, Sharma D, Kurkure PA, Ramadwar M, Viswanathan S, Rangarajan V, Qureshi S, Deshpande DD, Shrivastava SK, Dinshaw KA: Nasopharyngeal carcinoma in children: comparison of conventional and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys; 2008 Nov 1;72(3):728-36
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  • [Title] Nasopharyngeal carcinoma in children: comparison of conventional and intensity-modulated radiotherapy.
  • PURPOSE: To evaluate the efficacy of intensity-modulated radiotherapy (IMRT) in reducing the acute toxicities associated with conventional RT (CRT) in children with nasopharyngeal carcinoma.
  • PATIENTS AND METHODS: A total of 36 children with nonmetastatic nasopharyngeal carcinoma, treated at the Tata Memorial Hospital between June 2003 and December 2006, were included in this study.
  • Of the 36 patients, 28 were boys and 8 were girls, with a median age of 14 years; 4 (11%) had Stage II and 10 (28%) Stage III disease at presentation.
  • All patients had undifferentiated carcinoma and were treated with a combination of chemotherapy and RT.
  • RESULTS: After a median follow-up of 27 months, the 2-year locoregional control, disease-free, and overall survival rate was 76.5%, 60.6%, and 71.3%, respectively.
  • The median time to the development of Grade 2 toxicity was delayed with IMRT (skin, 35 vs. 25 days, p = 0.016; mucous-membrane, 39 vs. 27 days, p = 0.002; and larynx, 50 vs. 28 days, p = 0.009).
  • The average mean dose to the first and second planning target volume was 71.8 Gy and 62.5 Gy with IMRT compared with 66.3 Gy (p = 0.001) and 64.4 Gy (p = 0.046) with CRT, respectively.
  • CONCLUSION: The results of our study have shown that IMRT significantly reduces and delays the onset of acute toxicity, resulting in improved tolerance and treatment compliance for children with nasopharyngeal carcinoma.
  • Also, IMRT provided superior target coverage and normal tissue sparing compared with CRT.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy Dosage. Radiotherapy, Conformal. Radiotherapy, Intensity-Modulated / methods

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  • (PMID = 18374512.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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59. Lu JJ, Shakespeare TP, Tan LK, Goh BC, Cooper JS: Adjuvant fractionated high-dose-rate intracavitary brachytherapy after external beam radiotherapy in Tl and T2 nasopharyngeal carcinoma. Head Neck; 2004 May;26(5):389-95
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  • [Title] Adjuvant fractionated high-dose-rate intracavitary brachytherapy after external beam radiotherapy in Tl and T2 nasopharyngeal carcinoma.
  • BACKGROUND: The value of high-dose-rate intracavitary brachytherapy (HDRIB) for persistent or recurrent nasopharyngeal carcinoma has been well described; however, the benefit of routine adjuvant fractionated HDRIB following external beam radiation therapy (EBRT) has not been completely determined.
  • The objective of this analysis was to evaluate the outcome of two fractions of adjuvant HDRIB treatment in Tl and T2 nasopharyngeal carcinoma.
  • METHODS: Thirty-three consecutive and nonselected patients who had Tl and T2 non-disseminated nasopharyngeal carcinoma were treated according to an IRB approved institutional research protocol between March 1999 and July 2001.
  • By the 1997 AJCC cancer staging classification, 22 patients (67%) had Tl disease and 11 patients (33%) had T2 disease.
  • Seventeen of these patients who had stage I or stage II disease (i.e., NO or Nl) were treated with EBRT followed by two fractions of adjuvant HDRIB (group 1); 16 patients who had stage III or stage IV disease (i.e., N2 or N3) were treated with concurrent cisplatin, EBRT and adjuvant HDRIB and subsequent adjuvant cisplatin and fluorouracil (5-FU) chemotherapy (group 2).
  • EBRT was delivered by daily conventional fractionation to a total dose of 66 Gy to the primary tumor.
  • Nodal disease received 66 Gy if it was less than 3 cm in maximum diameter and 70 Gy if larger or there was palpable residual disease after 66 Gy.
  • A total of 10 Gy of HDRIB in 2 equal fractions of 5 Gy spaced 1 week apart was delivered starting 1 week after the completion of EBRT.
  • All patients were assessed for treatment response, local control, survival, and toxicity.
  • One patient died 7 months and one died 18 months after radiation therapy from the effects of distant metastases; two died of unrelated causes.
  • At the time of this analysis, one patient (3%) had persistent local disease and one patient (3%) developed pathologically confirmed local recurrence in the nasopharynx.
  • In addition, one patient (3%) developed recurrence only in a neck node followed by distant metastasis, and two patients (6%) developed distant metastasis without locoregional relapse.
  • The 2-year local control rate at the primary site was 93.6%, and the overall survival and disease-free survival rates were 82% and 74% respectively.
  • All patients experienced some degree of acute and/or late toxicity related to radiation therapy.
  • Ten patients (30%) experienced grade 3 acute and/or late toxicity and six patients (18%) developed grade 4 acute and/or late toxicity.
  • CONCLUSIONS: EBRT supplemented by two fractions of adjuvant HDRIB produced a 93.6% local control rate for Tl and T2 nasopharyngeal cancer at 2 years of follow up, with acceptable rates of acute and late toxicity.
  • Brief adjuvant HDRIB appears to permit dose escalation safely, even in patients who receive chemotherapy concurrently with conventional radiation therapy.
  • [MeSH-major] Brachytherapy / methods. Carcinoma / pathology. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / pathology. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Antineoplastic Combined Chemotherapy Protocols. Combined Modality Therapy. Dose Fractionation. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Prospective Studies. Radiotherapy Dosage. Radiotherapy, Adjuvant. Risk Assessment. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2004 Wiley Periodicals, Inc. Head Neck 26: 389-395, 2004.
  • (PMID = 15122654.001).
  • [ISSN] 1043-3074
  • [Journal-full-title] Head & neck
  • [ISO-abbreviation] Head Neck
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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60. Lee N, Xia P, Quivey JM, Sultanem K, Poon I, Akazawa C, Akazawa P, Weinberg V, Fu KK: Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys; 2002 May 1;53(1):12-22
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  • [Title] Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience.
  • PURPOSE: To update our experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: Between April 1995 and October 2000, 67 patients underwent IMRT for NPC at the University of California-San Francisco (UCSF).
  • The disease was Stage I in 8 (12%), Stage II in 12 (18%), Stage III in 22 (33%), and Stage IV in 25 (37%).
  • Fifty patients received concomitant cisplatinum and adjuvant cisplatinum and 5-FU chemotherapy according to the Intergroup 0099 trial.
  • The prescribed dose was 65-70 Gy to the gross tumor volume (GTV) and positive neck nodes, 60 Gy to the clinical target volume (CTV), 50-60 Gy to the clinically negative neck, and 5-7 Gy in 2 fractions for the intracavitary brachytherapy boost.
  • Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria.
  • Seventeen patients developed distant metastases; 5 of these patients have died.
  • Xerostomia decreased with time.
  • Analysis of the dose-volume histograms (DVHs) showed that the average maximum, mean, and minimum dose delivered were 79.3 Gy, 74.5 Gy, and 49.4 Gy to the GTV, and 78.9 Gy, 68.7 Gy, and 36.8 Gy to the CTV.
  • CONCLUSION: Excellent local-regional control for NPC was achieved with IMRT.
  • IMRT provided excellent tumor target coverage and allowed the delivery of a high dose to the target with significant sparing of the salivary glands and other nearby critical normal tissues.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Treatment Outcome

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2002 May 1;53(1):1-3 [12007933.001]
  • (PMID = 12007936.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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61. Geara FB, Nasr E, Tucker SL, Brihi E, Zaytoun G, Hadi U, Salem Z, El Saghir N, Issa P, Shamseddine A: Nasopharyngeal cancer in the Middle East: experience of the American University of Beirut Medical Center. Int J Radiat Oncol Biol Phys; 2005 Apr 1;61(5):1408-15
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  • [Title] Nasopharyngeal cancer in the Middle East: experience of the American University of Beirut Medical Center.
  • PURPOSE: To review the data of nasopharyngeal carcinoma (NPC) treated at the American University of Beirut Medical Center and reflect on the characteristics and treatment outcome of NPC in the Middle East compared with those of Western countries and countries in which NPC is endemic.
  • METHODS AND MATERIALS: Between 1966 and 1998, 151 patients with the diagnosis of NPC received definitive radiotherapy at the American University of Beirut Medical Center.
  • Most (60%) patients (n = 91) had Stage IV disease, 27% had Stage III, and 13% had Stage I or II disease; nodal disease was present in 117 patients (77%).
  • The pathologic type was predominantly lymphoepithelioma or World Health Organization type III (95 patients, 63%).
  • Treatment consisted of definitive radiotherapy alone for 116 patients (77%).
  • All others received induction chemotherapy, primarily with cisplatin-containing regimens.
  • The median radiation dose was 66 Gy (range, 47-73 Gy) to the primary and 67 Gy (range, 49-85 Gy) to involved neck nodes given at 2 Gy/fraction.
  • Using univariate analyses, the following factors significantly affected DFS: node size (<3 vs. 3-6 vs. >6 cm; p = 0.01), node level (upper vs. mid vs. lower neck; p = 0.004), and duration of radiotherapy (p = 0.002).
  • However, T stage, age, gender, radiation dose, use of chemotherapy, and histologic features had no statistically significant influence on DFS.
  • T stage, N stage, and histologic features were statistically significant variables for local control in the univariate analyses.
  • Using a Cox regression model, N stage (N1-N2 vs. N3; relative risk 2.09, p = 0.004) was identified as an independent variable for DFS, and N stage and pathologic features were identified as independent variables for local control.
  • Distant metastases were only affected by N stage (upper-mid vs. lower neck; p = 0.004).
  • CONCLUSION: Our results indicate that the characteristics of NPC patients in Lebanon and their parameters of outcome are comparable to those reported in Western series, particularly for the relative frequency and effect of lymphoepithelial histologic type.
  • Because of potential confounding factors, no definite conclusions about induction chemotherapy could be drawn from this retrospective study.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Analysis of Variance. Child. Female. Humans. Lebanon. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Radiation Injuries / etiology. Radiotherapy Dosage. Treatment Outcome

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  • (PMID = 15817344.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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62. Lee HW, Hwang YH, Han JH, Choi JH, Kang SY, Jeong SH, Ann MS, Oh YT, Kim JH, Kim CH, Sheen SS: High expression of excision repair cross-complementation group 1 protein predicts poor outcome in patients with nasopharyngeal cancer. Oral Oncol; 2010 Mar;46(3):209-13

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  • [Title] High expression of excision repair cross-complementation group 1 protein predicts poor outcome in patients with nasopharyngeal cancer.
  • We evaluated the prognostic significance of excision repair cross-complementation group 1 protein (ERCC1) and thymidylate synthase (TS) in patients with nasopharyngeal cancer (NPC) treated with concurrent chemoradiotherapy (CCRT).
  • Pre-treatment tumor biopsy specimens from 41 patients with locally advanced NPC (stage I: 1, II: 10, III: 9, IV: 21 patients) were analyzed for ERCC1 and TS expression by immunohistochemistry.
  • All patients were treated with one cycle of induction chemotherapy (5-fluorouracil 1000 mg/m(2)/day and cisplatin 20mg/m(2)/day, days 1-4) followed by CCRT starting on day 22.
  • CCRT consisted of radiotherapy (70 Gy/35 fractions for 7 weeks) with cisplatin 20mg/m(2)/day for 4 days on weeks 1, 4, and 7 of radiotherapy.
  • High expression of ERCC1 was associated with WHO type 1 or 2 histology (p=0.045).
  • In multivariate analysis, high expression of ERCC1 was a significant independent prognostic factor for poor OS (p=0.029) along with WHO type 1 or 2 histology.
  • High expression of ERCC1 protein may be a useful prognostic factor for poor outcome in patients with locally advanced NPC treated with CCRT.
  • [MeSH-major] DNA-Binding Proteins / metabolism. Endonucleases / metabolism. Nasopharyngeal Neoplasms / metabolism. Neoplasm Proteins / metabolism. Thymidylate Synthase / metabolism

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  • [Copyright] (c) 2009 Elsevier Ltd. All rights reserved.
  • (PMID = 20153243.001).
  • [ISSN] 1879-0593
  • [Journal-full-title] Oral oncology
  • [ISO-abbreviation] Oral Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA-Binding Proteins; 0 / Neoplasm Proteins; EC 2.1.1.45 / Thymidylate Synthase; EC 3.1.- / ERCC1 protein, human; EC 3.1.- / Endonucleases
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63. Ma B, Hui EP, King A, To KF, Mo F, Leung SF, Kam M, Lo YM, Zee B, Mok T, Ahuja A, Chan AT: A phase II study of patients with metastatic or locoregionally recurrent nasopharyngeal carcinoma and evaluation of plasma Epstein-Barr virus DNA as a biomarker of efficacy. Cancer Chemother Pharmacol; 2008 Jun;62(1):59-64
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  • [Title] A phase II study of patients with metastatic or locoregionally recurrent nasopharyngeal carcinoma and evaluation of plasma Epstein-Barr virus DNA as a biomarker of efficacy.
  • BACKGROUND: The epidermal growth factor receptor (EGFR) is commonly overexpressed in nasopharyngeal carcinoma (NPC) and gefitinib inhibits NPC growth in vitro.
  • METHOD: Patients who progressed after prior platinum-based chemotherapy for recurrent NPC were given gefitinib orally at 500 mg/day at a 28-day cycle.
  • The median age was 49 years (range 34-64 years), and most patients were males with metastatic NPC.
  • Radiological progression of disease coincided with rising levels of pEBV DNA in most patients, while the level of a patient with the longest duration of SD fell to an undetectable level at study completion.
  • The mean time to progression and overall survival was 2.7 (standard error, SE +/- 0.5 months) and 12 months (SE +/- 1.7 months), respectively.
  • No unexpected drug-related toxicities were seen.
  • The study was prematurely terminated because there was insufficient activity to warrant progression to the second stage of accrual.
  • CONCLUSION: This study found limited activity of gefitinib in recurrent NPC.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Biomarkers, Tumor / blood. DNA, Viral / blood. Herpesvirus 4, Human / chemistry. Nasopharyngeal Neoplasms / diagnosis. Nasopharyngeal Neoplasms / drug therapy. Quinazolines / therapeutic use

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  • (PMID = 17762933.001).
  • [ISSN] 0344-5704
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / DNA, Viral; 0 / Quinazolines; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; S65743JHBS / gefitinib
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64. M'Rabti H, Sbiti Y, Afqir S, Boutayeb S, Errihani H: [Chemotherapy in nasopharyngeal carcinoma]. Ann Otolaryngol Chir Cervicofac; 2006 Apr;123(2):59-64
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  • [Title] [Chemotherapy in nasopharyngeal carcinoma].
  • [Transliterated title] La chimiothérapie dans les cancers du cavum.
  • Nasopharyngeal carcinoma (NC), especially the undifferenciated type, is a rare malignant disease.
  • OBJECTIVES: To determine the role of chemotherapy in the treatment of cancers of the nasopharynx.
  • MATERIAL AND METHODS: [corrected] A search of the MEDLINE databases from 1970 to 2005, for articles testing chemotherapy in nasopharyngeal carcinoma.
  • The key words: Nasopharyngeal carcinoma, chemotherapy, concurrent chemo-radiation, were used to access to principal trials.
  • RESULTS: Nine phase III randomised trials, testing the combination of chemotherapy and radiotherapy in nasopharyngeal carcinoma were found.
  • There us increasing evidence attesting to the beneficial effect of adding of chemotherapy to radiotherapy in the treatment of locally advanced disease (stage III and IV), especially concurrent chemo-radiation, considering the benefit in terms of overall survival.
  • New molecules (capecitabine, taxanes, gemcitabine...) are currently in the course of testing, in phase II studies, for recurrent and metastatic NC, for which there is not still standard treatment.
  • CONCLUSION: Medline review reveals that concurrent chemo-radiation, containing cisplatin, is standard treatment for locally advanced nasopharyngeal carcinoma.
  • Metastatic disease is treated by palliative chemotherapy.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy

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  • (PMID = 16733467.001).
  • [ISSN] 0003-438X
  • [Journal-full-title] Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris
  • [ISO-abbreviation] Ann Otolaryngol Chir Cervicofac
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 31
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65. Huang GX, Zhao C, Han F, Zhang B, Qiu HJ, Xu BP, Chen XX, Hu PL: [Clinical study in prophylactic use of chinese medicine to prevent chemoradiotherapy induced mucositis in nasopharyngeal carcinoma]. Ai Zheng; 2003 Oct;22(10):1084-7
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  • [Title] [Clinical study in prophylactic use of chinese medicine to prevent chemoradiotherapy induced mucositis in nasopharyngeal carcinoma].
  • BACKGROUND & OBJECTIVE: Oropharyngeal mucositis is the most common acute non-hematology toxicity in nasopharyngeal carcinoma (NPC) treated with radiotherapy, especially in the concomitant chemoradiotherapy of local advanced NPC patients.
  • This study was designed to observe the effect of traditional Chinese medicine against acute oropharyngeal mucositis from chemoradiotherapy in patients with local advanced NPC.
  • METHODS: A total of 101 patients in stage III- IVa (Fuzhou 1992) were enrolled into this prospective randomized clinical trial.
  • The cases were divided into treatment group (52 cases) and control group (49 cases).
  • The median doses were 70.31+/-1.21 Gy for the treatment group and 70.78+/-1.95 Gy for the control group, respectively.
  • Chemotherapy was concomitant with radiotherapy [single agent cisplatin (DDP,30 mg/m(2)) 6 times from first to sixth week of radiotherapy duration].
  • The patients of treatment group took 5-8 times of Chinese medicine daily and those of control group took 5-8 times of Dobell's solution daily.The observation indices included the degree of oropharyngeal and hematological toxicity, radiotherapy duration, and curative effect.
  • RESULTS: (1)Oropharyngeal toxicity: there was no 0 degree oropharyngeal toxicity in both groups, I degree toxicity in 29 cases (55.77%) and 2 cases (4.08%), II degree toxicity in 18 cases (34.62%) and 17 cases (30.69%), III degree toxicity in 5 cases (9.62%) and 22 cases (44.89%), IV degree toxicity in 0 case (0%) and 8 cases (16.33%); there was statistical significance of difference between the two groups (P=0.000). (2)Hematological toxicity: there was no IV degree hematological toxicity in both groups.
  • CONCLUSION: Chinese medicine was effective in reducing acute oropharyngeal toxicity resulting from chemoradiotherapy in patients with local advanced NPC.
  • Chinese medicine treatment did not affect the short-term clinical outcome.
  • [MeSH-major] Medicine, Chinese Traditional. Mucositis / prevention & control. Nasopharyngeal Neoplasms / therapy
  • [MeSH-minor] Acute Disease. Adult. Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Prospective Studies. Time Factors

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  • (PMID = 14558957.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
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66. Yao K, Takahashi H, Inagi K, Nakayama M, Makoshi T, Nagai H, Okamoto M: Carcinoma of the nasopharynx: analysis of treatment results in 91 patients. Acta Otolaryngol Suppl; 2002;(547):20-4

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Carcinoma of the nasopharynx: analysis of treatment results in 91 patients.
  • The outcome of 91 patients (69 males, 22 females; age range 16-82 years) with nasopharyngeal carcinoma treated in our hospital between 1971 and 1999 was evaluated.
  • The 1997 International Union Against Cancer classification was used for disease staging.
  • The 5-year survival rates were as follows: 66.7% (n = 3) for Stage I; 100% (n = 2) for Stage IIA; 90.9% (n = 11) for Stage IIB; 78.8% (n = 25) for Stage III; 53.0% (n = 29) for Stage IVA; 37.5% (n = 16) for Stage IVB; and 20.0% (n = 5) for Stage IVC.
  • The disease-free cumulative 3-year survival rates of the patients classified based on initial therapy were as follows: radiation alone, 50.0% (n = 28); combined radiotherapy and chemotherapy that included an undefined anti-cancer drug, 67.2% (n = 39); combined radiotherapy and chemotherapy that included carboplatin (CBDCA), 92.3% (n = 19).
  • Stage IVC patients were excluded from the analysis.
  • We conclude that combined therapy, including chemotherapy with CBDCA, is necessary for the treatment of nasopharyngeal carcinoma.
  • In terms of radiation therapy, a field covering the bilateral cervical regions seemed to produce favorable results, even if cervical node metastasis was not confirmed by palpation at the first hospital visit.
  • Key words: carboplatin, chemotherapy,
  • [MeSH-major] Carcinoma / mortality. Carcinoma / therapy. Nasopharyngeal Neoplasms / mortality. Nasopharyngeal Neoplasms / therapy. Outcome Assessment (Health Care) / statistics & numerical data

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  • (PMID = 12212588.001).
  • [ISSN] 0365-5237
  • [Journal-full-title] Acta oto-laryngologica. Supplementum
  • [ISO-abbreviation] Acta Otolaryngol Suppl
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Norway
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67. Bae WK, Hwang JE, Shim HJ, Cho SH, Lee JK, Lim SC, Chung WK, Chung IJ: Phase II study of docetaxel, cisplatin, and 5-FU induction chemotherapy followed by chemoradiotherapy in locoregionally advanced nasopharyngeal cancer. Cancer Chemother Pharmacol; 2010 Feb;65(3):589-95
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  • [Title] Phase II study of docetaxel, cisplatin, and 5-FU induction chemotherapy followed by chemoradiotherapy in locoregionally advanced nasopharyngeal cancer.
  • PURPOSE: This study sought to determine the feasibility and safety of induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (5-FU) triple combination chemotherapy (TPF) followed by concurrent chemoradiotherapy (CCRT) for locoregionally advanced nasopharyngeal cancer (NPC).
  • METHODS: Patients with advanced NPC were treated with three cycles of induction chemotherapy.
  • After induction chemotherapy, cisplatin was given at a dose of 100 mg/m2 every 3 weeks with radiotherapy.
  • RESULTS: Thirty-three patients were enrolled; all patients were stage III (n=4, 12.1%) or IV (n=29, 87.9%).
  • Among the patients, 32 patients completed both induction TPF therapy and CCRT, with responses as follows: Wve patients (15.2%) achieved a complete response (CR), and 27 patients (81.8%) a partial response (PR).
  • Neutropenia (72.7%), febrile neutropenia (9.1%), and nausea (9.1%) were the most severe toxicities (grade 3-4) during induction chemotherapy, and mucositis (39.4%), fatigue (15.2%), and nausea (9.1%) were the most common toxicities (grade 3-4) during CCRT.
  • CONCLUSIONS: Although most patients had stage IV NPC, the TPF induction chemotherapy followed by CCRT showed promising activity with manageable toxicity.
  • These results demonstrated the possibility of effective treatment with the aim of not only a palliative, but also a curative, approach to the treatment of advanced NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Drug Administration Schedule. Feasibility Studies. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Mucositis / chemically induced. Nausea / chemically induced. Neoplasm Staging. Neutropenia / chemically induced. Taxoids / administration & dosage. Taxoids / adverse effects. Treatment Outcome

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  • (PMID = 19830427.001).
  • [ISSN] 1432-0843
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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68. Hui EP, Ma BB, Leung SF, King AD, Mo F, Kam MK, Yu BK, Chiu SK, Kwan WH, Ho R, Chan I, Ahuja AT, Zee BC, Chan AT: Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma. J Clin Oncol; 2009 Jan 10;27(2):242-9
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  • [Title] Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma.
  • PURPOSE: To compare the toxicities, tumor control, survival, and quality of life of nasopharyngeal cancer (NPC) patients treated with sequential neoadjuvant chemotherapy followed by concurrent cisplatin-radiotherapy (CRT) or CRT alone.
  • PATIENTS AND METHODS: Previously untreated stage III to IVB NPC were randomly assigned to (1) neoadjuvant docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2) every 3 weeks for two cycles, followed by cisplatin 40 mg/m(2)/wk concurrent with radiotherapy, or (2) CRT alone.
  • RESULTS: From November 2002 to November 2004, 65 eligible patients were randomly assigned to neoadjuvant chemotherapy followed by CRT (n = 34) or CRT alone (n = 31).
  • There was a high rate of grade 3/4 neutropenia (97%) but not neutropenic fever (12%) during neoadjuvant chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Drug Administration Schedule. Female. Humans. Infusions, Intravenous. Male. Middle Aged. Neoadjuvant Therapy. Quality of Life. Survival Rate. Taxoids / administration & dosage. Taxoids / adverse effects. Treatment Outcome


69. Wu RR, Wu SX, Zhao C, Xie FY, Gao JM, Hu WH, Gao YH, Li FY, Cui TT, Lu TX: [Phase II clinical trial of h-R3 combined radiotherapy for locoregionally advanced nasopharyngeal carcinoma]. Ai Zheng; 2007 Aug;26(8):874-9
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  • [Title] [Phase II clinical trial of h-R3 combined radiotherapy for locoregionally advanced nasopharyngeal carcinoma].
  • This may influence therapeutic effect.
  • This study was to evaluate the short-term and long-term efficacy and toxicity of the humanized anti-EGFR monoclonal antibody h-R3 in combination with radiotherapy for locoregionally advanced nasopharyngeal carcinoma (NPC).
  • METHODS: Patients with newly diagnosed stage III-IVb (UICC 1997) NPC, who had moderate or strong EGFR expression, were randomized into radiotherapy alone group or radiotherapy combined h-R3 group.
  • During treatment, only 1 patient withdrew from the combination group.
  • The overall complete remission (CR) rates at the end of treatment, 5 and 17 weeks after treatment were significantly higher in combination group than in radiotherapy alone group (72.2% vs. 35.3%, 83.3% vs. 41.2%, and 83.3% vs. 47.1%, P<0.05).
  • Median follow-up time was 31.9 months (range, 4.2-40.7 months).
  • No significant differences in 3-year locoregional control, distant metastasis-free survival and overall survival rates between the 2 groups were found.
  • Except for 1 patient suffered from grade 2 vomiting, no patient developed other adverse events in combination group.
  • No significant differences in radiotherapy-related adverse events between the 2 groups were observed.
  • CONCLUSIONS: h-R3 is a safe drug which may enhance the response of advanced NPC patients to radiotherapy.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Carcinoma / therapy. Nasopharyngeal Neoplasms / therapy. Receptor, Epidermal Growth Factor / immunology
  • [MeSH-minor] Adult. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Particle Accelerators. Radiotherapy, High-Energy. Remission Induction. Survival Rate

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  • (PMID = 17697551.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] Clinical Trial, Phase II; English Abstract; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; EC 2.7.10.1 / Receptor, Epidermal Growth Factor
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70. Taheri-Kadkhoda Z, Björk-Eriksson T, Johansson KA, Mercke C: Long-term treatment results for nasopharyngeal carcinoma: the Sahlgrenska University Hospital experience. Acta Oncol; 2007;46(6):817-27
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  • [Title] Long-term treatment results for nasopharyngeal carcinoma: the Sahlgrenska University Hospital experience.
  • Nasopharyngeal carcinoma (NPC) is a rare disease in Sweden.
  • For evaluation of the treatment outcomes in our NPC patients, 52 new cases that were referred to our department between 1991 and 2002 were retrospectively analysed.
  • Tumor stage, according to the 1997 AJCC staging system, was I in five, II in ten, III in 12 and IV in 25 patients.
  • Majority of the patients (87%) had World Health Organization type II-III tumors.
  • Neoadjuvant chemotherapy was delivered in 33 patients.
  • Thirty-two patients received hyperfractionated accelerated radiation therapy with a median dose of 64.6Gy (1.7Gy/fr bid).
  • Two patients were excluded from the analysis due to treatment refusal.
  • For the patients with tumor stages I-IVB, the 5-year disease-free and overall survival rates were 61% and 55%, respectively.
  • Our data suggest that optimization of the treatment outcomes in NPC patients requires implementation of new therapeutic strategies.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Treatment Outcome
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Child. Cisplatin / therapeutic use. Female. Health Surveys. Hospitals, University. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Retrospective Studies. Survival Analysis. Sweden. Time Factors

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  • (PMID = 17653906.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Norway
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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71. Yen RF, Chen TH, Ting LL, Tzen KY, Pan MH, Hong RL: Early restaging whole-body (18)F-FDG PET during induction chemotherapy predicts clinical outcome in patients with locoregionally advanced nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging; 2005 Oct;32(10):1152-9
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  • [Title] Early restaging whole-body (18)F-FDG PET during induction chemotherapy predicts clinical outcome in patients with locoregionally advanced nasopharyngeal carcinoma.
  • PURPOSE: This study was undertaken to evaluate the utility of whole-body (18)F-FDG PET in monitoring therapeutic effect during induction chemotherapy (IC) and in predicting prognosis in patients with locoregionally advanced nasopharyngeal carcinoma (NPC).
  • METHODS: Fifty patients who had histologically proven, locoregionally advanced NPC without distant metastasis and had received IC were recruited in this study.
  • Patients who were downstaged to stage I or II were classified as major responders; the rest were classified as non-major responders.
  • RESULTS: Only 1 of the 23 major responders subsequently developed local recurrence.
  • At the time of data analysis, all major responders were alive; by contrast, of the 27 non-major responders, 15 had locoregional recurrence or distant metastasis and nine had died (seven of NPC and two of treatment-related complications).
  • Kaplan-Meier survival analysis showed significantly longer recurrence-free survival and overall survival in major responders (56.4+/-9.2 and 58.1+/-2.2 months) as compared with non-major responders (33.7+/-23.2 and 44.7+/-20.0 months), with p<0.0001 and p=0.0024, respectively.
  • CONCLUSION: The results of this study suggest that early restaging by a single whole-body (18)F-FDG PET scan after the first or second course of IC is useful for predicting therapeutic response and outcome in patients with locoregionally advanced NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Fluorodeoxyglucose F18. Nasopharyngeal Neoplasms / diagnostic imaging. Nasopharyngeal Neoplasms / drug therapy. Neoplasm Recurrence, Local / diagnostic imaging. Positron-Emission Tomography / statistics & numerical data. Whole Body Imaging / statistics & numerical data
  • [MeSH-minor] Adolescent. Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiopharmaceuticals. Reproducibility of Results. Sensitivity and Specificity. Survival Analysis. Survival Rate. Taiwan / epidemiology. Treatment Outcome

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  • (PMID = 15965687.001).
  • [ISSN] 1619-7070
  • [Journal-full-title] European journal of nuclear medicine and molecular imaging
  • [ISO-abbreviation] Eur. J. Nucl. Med. Mol. Imaging
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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72. Alieva SB, Tkachëv SI, Matiakin EG, Kondrat'eva AP, Zimina NA, Sakharovskaia VG, Iachmeneva NF, Romanov IS: [A comparison of two modalities of complex chemoradiotherapy for locally advanced nasopharyngeal carcinoma]. Vopr Onkol; 2004;50(6):701-5
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  • [Title] [A comparison of two modalities of complex chemoradiotherapy for locally advanced nasopharyngeal carcinoma].
  • Two modalities of complex chemoradiotherapy for locally advanced nasopharyngeal carcinoma stage III-IV were compared in the treatment of 52 patients.
  • --4, and prednisolone 100 mg/sq.m, per os, days 1-5; group II (18)--cisplatin 100 mg/sq.m, day 4, plus 5-FU 1,000 mg, i.v.
  • Full response was registered in 93.7% (group I) and 93.3% (group II).
  • Overall 5-year and relapse-free survival was 85 and 63% (group I), and 83 and 56% (group II), respectively.
  • The best results were reported with chemoradiotherapy using two courses: an induction one and an adjuvant cisplatin drugs treatment concurrent with ACOP or 5-FU.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Infusions, Intravenous. Injections, Intravenous. Male. Middle Aged. Neoplasm Staging. Prednisolone / administration & dosage. Radiotherapy, Adjuvant. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 15755067.001).
  • [ISSN] 0507-3758
  • [Journal-full-title] Voprosy onkologii
  • [ISO-abbreviation] Vopr Onkol
  • [Language] rus
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Russia
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; VAP-cyclo protocol
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73. Xu L, Pan J, Wu J, Pan C, Zhang Y, Lin S, Yang L, Chen C, Zhang C, Zheng W, Lin S, Ni X, Kong FM: Factors associated with overall survival in 1706 patients with nasopharyngeal carcinoma: significance of intensive neoadjuvant chemotherapy and radiation break. Radiother Oncol; 2010 Jul;96(1):94-9
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  • [Title] Factors associated with overall survival in 1706 patients with nasopharyngeal carcinoma: significance of intensive neoadjuvant chemotherapy and radiation break.
  • BACKGROUND AND PURPOSE: To exam factors associated with overall survival (OS) in patients with nasopharyngeal carcinoma (NPC).
  • MATERIALS AND METHODS: This study is a retrospective study of a total of 1706 consecutive NPC patients from a single institution between January 1995 and December 1998.
  • One thousand eighty-one patients were treated with radiotherapy (RT) alone and 625 with an intensive course of neoadjuvant chemotherapy followed by RT.
  • Patient, tumor and treatment factors were analyzed for their significance on 5-year overall survival (OS).
  • RESULTS: Younger age, female gender, absence of anemia pre-RT, early tumor stage, interruption of RT, and neoadjuvant chemotherapy were significantly associated with survival under multivariate analysis (all P<0.05).
  • The 5-year OS rates were 100%, 75.9% (95%CI 71.6-80.2%), 66.5% (95%CI 62.8-70.2%), and 49.3% (95%CI 45.0-53.6%) for stage I, II, III, and IV (P<0.05); 68.9% (95%CI 66.2-71.5%) and 63.7% (95%CI 61.5-65.8%), for patients treated with or without neoadjuvant chemotherapy (P=0.0051), and 51.7% (95%CI 45.0-58.4%) and 69.5% (95%CI 67.2-71.7%) for patients with or without treatment break (P<0.0001), respectively.
  • CONCLUSION: Intensive neoadjuvant chemotherapy and absence of radiation break seem to be favorable factors associated with long-term survival in patients with NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / mortality. Nasopharyngeal Neoplasms / therapy. Neoadjuvant Therapy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. China. Combined Modality Therapy. Disease-Free Survival. Dose-Response Relationship, Drug. Dose-Response Relationship, Radiation. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Multivariate Analysis. Neoplasm Invasiveness / pathology. Neoplasm Staging. Prognosis. Proportional Hazards Models. Radiotherapy Dosage. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Time Factors. Treatment Outcome

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  • [Copyright] Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
  • (PMID = 20435361.001).
  • [ISSN] 1879-0887
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Ireland
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74. Liu S, Xue Y, Zhang H, Liang JG, Lu XP, Liu XG, Chen SX, Jing NY: [Preliminary study on the value of 99Tc(m)-HL91 imaging in predicting sensitivity to radiotherapy in patients with nasopharyngeal carcinoma]. Zhonghua Zhong Liu Za Zhi; 2007 May;29(5):369-72
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  • [Title] [Preliminary study on the value of 99Tc(m)-HL91 imaging in predicting sensitivity to radiotherapy in patients with nasopharyngeal carcinoma].
  • OBJECTIVE: To investigate the feasibility of 9Tc(m)-HL91 imaging in prediction of 34 radiotherapy sensitivity of naqsopharyngeal cancer( NPC) and its relationship with prognosis.
  • METHODS: patients with NPC confirmed by pathology, staging from II-IVa, underwent 99Tc(m)-HL91 SPECT imaging one week before radiotherapy.
  • 18 of them received adjuvant chemotherapy.
  • The hypoxia in primary nasopharyngeal lesions and cervical lymph node metastases were calculated semi-quantitatively, and compared with clinical findings in medium-term therapy at 4 months and 1 year post therapy. RESULTS:.
  • (1) There was no significant relationship between the total preliminary curative effect of adjuvant chemotherapy and the degree of nasopharyngeal lesion hypoxia (T/Mu, gamma = -0.394, P = 0.145; T/ Ce gamma = -0.510, P = 0.052).
  • But there was a significant difference between the partial curative effect group and significant curative effect group. (2) The degree of NPC regression in the medium-term radiotherapy group was negatively correlated with the degree of hypoxia (T/Mu, gamma = -0.602; T/Ce, gamma = -0.643, P < 0.01). (3) 23 patients had good local control except one case with lung and bone metastasis 4 months post-therapy.
  • The lesions disappeared or not developed in 6 patients (T/Mu 1.30 +/- 0.23, T/Ce 3.61 +/- 0.84).
  • Two patients at stage III and IVa relapsed (T/Mu were 1.40 and 1.27, respectively; T/Ce were 4.10 and 3.85, respectively), there was no significant difference. (4) The degree of lymph node hypoxia had no correlation with the curative effect on medium-term radiotherapy.
  • CONCLUSION: 99 Tc(m)-HL91 hypoxia imaging may predict sensitivity to radiotherapy in patients with NPC, with a potential help to carry out individual therapy.
  • However, further investigation is needed to ascertain whether it could predict the long-time curative effect on NPC radiotherapy.
  • [MeSH-major] Nasopharyngeal Neoplasms / radionuclide imaging. Organotechnetium Compounds. Oximes
  • [MeSH-minor] Adult. Aged. Anoxia. Chemotherapy, Adjuvant. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Particle Accelerators. Preoperative Care / methods. Prognosis. Radiotherapy, High-Energy. Remission Induction. Reproducibility of Results. Tomography, Emission-Computed, Single-Photon

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  • (PMID = 17892134.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Organotechnetium Compounds; 0 / Oximes; 0 / technetium Tc 99m 4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime
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75. Lertbutsayanukul C, Khorprasert C, Shotelersuk K, Jumpangern C, Sanghangthum T, Oonsiri S, Ayuthaya II, Suriyapee S, Wadwongtham W, Supanakorn S, Kerekanjanarong V, Rojpornpradit P: Intensity-modulated radiation therapy in head-and-neck cancer, first report in Thailand. J Med Assoc Thai; 2006 Dec;89(12):2068-76
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  • [Title] Intensity-modulated radiation therapy in head-and-neck cancer, first report in Thailand.
  • OBJECTIVE: This is the first report in Thailand to evaluate the efficacy of using intensity-modulated radiotherapy (IMRT) in the primary treatment of head-and-neck cancer.
  • MATERIAL AND METHOD: From July 2005 to March 2006, eighteen patients with head and neck cancer were treated with IMRT, fourteen of which were nasopharyngeal cancer.
  • The median age at diagnosis was 52 years (range 23-58 years).
  • The treatment plan composed of two sequential plans for PTV-low risk (50Gy in 25 fractions) and PTV-high risk (20Gy in 10 fractions).
  • Chemotherapy was given to 13 patients with locoregionally advanced disease (stage T3/T4 and N2/3) using cisplatin (n = 3) or carboplatin (n = 10) every 3 weeks during the course of radiation therapy.
  • RESULTS: The median overall treatment time was 49 days (range, 43-57 days), and 77.8 percent of the patients completed 35 fractions within 50 days.
  • Treatment break during RT range from 3 to 7 days, was observed in three patients.
  • CONCLUSION: The authors' experience of using concurrent chemotherapy with IMRT for a cohort of patients with head and neck carcinoma showed a very high rate response rate at early follow-up.
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Retrospective Studies. Survival Rate. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 17214058.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Thailand
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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76. Chang JT, Lin CY, Chen TM, Kang CJ, Ng SH, Chen IH, Wang HM, Cheng AJ, Liao CT: Nasopharyngeal carcinoma with cranial nerve palsy: the importance of MRI for radiotherapy. Int J Radiat Oncol Biol Phys; 2005 Dec 1;63(5):1354-60
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  • [Title] Nasopharyngeal carcinoma with cranial nerve palsy: the importance of MRI for radiotherapy.
  • PURPOSE: To evaluate various prognostic factors and the impact of imaging modalities on tumor control in patients with nasopharyngeal cancer (NPC) with cranial nerve (CN) palsy.
  • MATERIAL AND METHODS: Between September 1979 and December 2000, 330 NPC patients with CN palsy received radical radiotherapy (RT) by the conventional opposing technique at Chang Gung Memorial Hospital-Linkou.
  • Imaging methods used varied over that period, and included conventional tomography (Tm) for 47 patients, computerized tomography (CT) for 195 patients, and magnetic resonance image (MRI) for 88 patients.
  • Upper CN (II-VI) palsy was found in 268 patients, lower CN (IX-XII) in 13, and 49 patients had both.
  • The median external RT dose was 70.2 Gy (range, 63-77.5 Gy).
  • A total of 139 patients received cisplatin-based chemotherapy, in 115 received as neoadjuvant or adjuvant chemotherapy and in 24 concomitant with RT.
  • Brachytherapy was associated with poorer local control, whereas a total external dose of more than 70 Gy improved local tumor control and marginally improved DSS.
  • Subgroup analysis in CT and MRI patients group, either DSS or OS was significantly associated with imaging modality, N stage, or location of or remission of CN palsy.
  • CONCLUSION: The use of MRI was associated with improved tumor control and survival of patients with NPC causing CN palsy.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Cranial Nerve Diseases / radiotherapy. Magnetic Resonance Imaging. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging / methods. Prognosis. Recovery of Function. Retrospective Studies. Tomography, X-Ray Computed

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  • (PMID = 16297716.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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77. Fountzilas G, Tolis C, Kalogera-Fountzila A, Karanikiotis C, Bai M, Misailidou D, Samantas E, Athanassiou E, Papamichael D, Tsekeris P, Catodritis N, Nicolaou A, Plataniotis G, Makatsoris T, Papakostas P, Zamboglou N, Daniilidis J: Induction chemotherapy with cisplatin, epirubicin, and paclitaxel (CEP), followed by concomitant radiotherapy and weekly paclitaxel for the management of locally advanced nasopharyngeal carcinoma. A Hellenic Cooperative Oncology Group phase II study. Strahlenther Onkol; 2005 Apr;181(4):223-30
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  • [Title] Induction chemotherapy with cisplatin, epirubicin, and paclitaxel (CEP), followed by concomitant radiotherapy and weekly paclitaxel for the management of locally advanced nasopharyngeal carcinoma. A Hellenic Cooperative Oncology Group phase II study.
  • BACKGROUND: Clinical research on the treatment of nasopharyngeal cancer (NPC) has been focused primarily on the reduction of incidence of the development of distant metastases as well as the improvement of locoregional control.
  • PATIENTS AND METHODS: Untreated patients with stage IIB-IVB nonmetastatic NPC were treated with three cycles of induction chemotherapy (IC) consisting of epirubicin 75 mg/m(2) followed by paclitaxel 175 mg/m(2) as 3-h infusion on day 1 and cisplatin 75 mg/m(2) on day 2 every 3 weeks, followed by concomitant radiation therapy (70 Gy), and chemotherapy (CCRT) with weekly paclitaxel 60 mg/m(2).
  • Complete response rate post IC therapy was 15%, which was raised to 66% after the completion of CCRT.
  • The presence of Epstein-Barr virus (EBV) was detected either by in situ hybridization in tumor tissue sections or by polymerase chain reaction in the peripheral blood in 37 out of 46 patients tested (80%).
  • All three histological types were associated with the presence of EBV.
  • After a median follow-up of 23.5 months, median time to treatment failure was 17.9 months, whilst median survival has not been reached yet.
  • CONCLUSION: IC followed by CCRT is feasible and produces durable complete responses in the majority of patients with NPC.
  • The case detection rate of EBV in this study appears to be similar to that reported from endemically infected regions.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / toxicity. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Epirubicin / administration & dosage. Female. Humans. Leukocyte Count. Male. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Patient Selection. Platelet Count

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  • (PMID = 15827691.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] Germany
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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78. Palazzi M, Guzzo M, Tomatis S, Cerrotta A, Potepan P, Quattrone P, Cantù G: Improved outcome of nasopharyngeal carcinoma treated with conventional radiotherapy. Int J Radiat Oncol Biol Phys; 2004 Dec 1;60(5):1451-8
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  • [Title] Improved outcome of nasopharyngeal carcinoma treated with conventional radiotherapy.
  • PURPOSE: To describe the outcome of patients with nonmetastatic nasopharyngeal carcinoma (NPC) treated with conventional radiotherapy at a single institution.
  • METHODS AND MATERIALS: From 1990 to 1999, 171 consecutive patients with NPC were treated with conventional (two-dimensional) radiotherapy.
  • Tumor-node-metastasis Stage (American Joint Committee on Cancer/International Union Against Cancer 1997 system) was I in 6%, II in 36%, III in 22%, and IV in 36% of patients.
  • Mean total radiation dose was 68.4 Gy.
  • Chemotherapy was given to 62% of the patients.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Analysis of Variance. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Survival Analysis. Treatment Outcome

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  • (PMID = 15590176.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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79. El-Weshi A, Khafaga Y, Allam A, Mosseri V, Ibrahim E, El-Serafi M, El-Badawi S: Neoadjuvant chemotherapy plus conventional radiotherapy or accelerated hyperfractionation in stage III and IV nasopharyngeal carcinoma--a phase II study. Acta Oncol; 2001;40(5):574-81
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  • [Title] Neoadjuvant chemotherapy plus conventional radiotherapy or accelerated hyperfractionation in stage III and IV nasopharyngeal carcinoma--a phase II study.
  • A prospective phase II trial was initiated in previously untreated patients with locally advanced nasopharyngeal carcinoma (NPC).
  • The goal was to achieve improvement in locoregional control, disease-free interval and overall survival using induction chemotherapy and to compare conventional fractionation (CF) with an accelerated hyperfractionation (AHF) regimen.
  • Fifty patients were treated (5 AJCC Stage III, 45 Stage IV) with induction chemotherapy consisting of two cycles of cisplatin and 5-fluorouracil.
  • Patients were then randomized between CF and AHF therapy.
  • A clinical response to induction chemotherapy was reported in 86% of patients prior to radiotherapy (44% complete response, 42% partial response).
  • Patients with complete or major partial responses to induction chemotherapy had a significantly better 5-year overall survival (60%) and disease-free interval (59%) than those with no response or minor partial response (15% and 18% p = 0.009 and 0.0009).
  • Acute radiation reactions were more pronounced in the AHF group (p = 0.0002), and the incidence of late normal tissue injury was more frequent (p = 0.08).
  • The overall treatment failure rate was 48%.
  • Response to induction chemotherapy is strongly predictive for locoregional control, disease-free interval and overall survival.
  • The optimal chemotherapy dose and sequencing with radiotherapy needs to be investigated in future studies.
  • Distant metastases remain the main cause of treatment failure in NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma, Squamous Cell / drug therapy. Chemotherapy, Adjuvant. Dose Fractionation. Nasopharyngeal Neoplasms / drug therapy. Radioisotope Teletherapy / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Cisplatin / adverse effects. Cisplatin / therapeutic use. Disease-Free Survival. Female. Fluorouracil / adverse effects. Fluorouracil / therapeutic use. Humans. Life Tables. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local. Prospective Studies. Radiation Injuries / etiology. Survival Analysis. Treatment Outcome

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  • (PMID = 11669328.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] Norway
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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80. Bucci MK, Rosenthal DI, Hershock D, Metz J, Devine P, Kligerman MM, Machtay M: Final report of a pilot trial of accelerated radiotherapy plus concurrent 96-hour infusional paclitaxel for locally advanced head and neck cancer. Am J Clin Oncol; 2004 Dec;27(6):595-602
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  • [Title] Final report of a pilot trial of accelerated radiotherapy plus concurrent 96-hour infusional paclitaxel for locally advanced head and neck cancer.
  • Eligible patients had stage IV squamous cell carcinoma of the head and neck, exclusive of nasopharynx cancer.
  • XRT was given continuous course using an accelerated regimen with twice a day fractionation for the cone down (70-72 Gy/6 weeks).
  • Chemotherapy consisted of 2 cycles of paclitaxel via 96-hour infusion during weeks 1 and 5 of XRT.
  • Median treatment time was 44 days, and all but 1 patient received both cycles of paclitaxel at their planned dose.
  • Four patients (18%) developed distant metastases.
  • Two patients (9%) developed severe esophageal strictures requiring permanent gastrostomy/tracheostomy, and 2 patients developed other late grade 3+ toxicities.
  • Further study of accelerated XRT with concurrent chemotherapy is indicated.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / radiotherapy. Paclitaxel / therapeutic use. Radiation-Sensitizing Agents / therapeutic use
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Infusions, Intravenous. Male. Middle Aged. Pilot Projects. Radiotherapy Dosage. Survival Analysis

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  • (PMID = 15577438.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Controlled Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Radiation-Sensitizing Agents; P88XT4IS4D / Paclitaxel
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81. Abitbol A, Abdel-Wahab M, Lewin A, Troner M, Rodrigues MA, Hamilton-Nelson KL, Markoe A: Phase II study of tolerance and efficacy of hyperfractionated radiotherapy and 5-fluorouracil, cisplatin, and paclitaxel (Taxol) in stage III and IV inoperable and/or unresectable head-and-neck squamous cell carcinoma: A-2 protocol. Int J Radiat Oncol Biol Phys; 2002 Jul 15;53(4):942-7
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  • [Title] Phase II study of tolerance and efficacy of hyperfractionated radiotherapy and 5-fluorouracil, cisplatin, and paclitaxel (Taxol) in stage III and IV inoperable and/or unresectable head-and-neck squamous cell carcinoma: A-2 protocol.
  • PURPOSE: To determine the toxicity and efficacy of concurrent 5-fluorouracil (5-FU), cisplatin, and paclitaxel (Taxol) and hyperfractionated radiotherapy in locally advanced squamous cell carcinoma of the head and neck.
  • METHODS AND MATERIALS: Twenty-seven patients were entered into this Phase II trial.
  • Eligible patients had Stage III or IV head-and-neck squamous cell carcinoma arising from the oral cavity, hypopharynx, oropharynx, nasopharynx, or larynx.
  • The plan of treatment consisted of hyperfractionated radiotherapy (74.4 Gy at twice daily fractions of 1.2 Gy).
  • Chemotherapy was given on Weeks 1, 5, and 8 as follows: 5-FU at 750 mg/m2 as a constant infusion for 24 h for 3 days; cisplatin at 50 mg/m2 in 250-500 mL D5 0.5 NS or NS infusion during 2-4 h, and paclitaxel at 70 mg/m2 infused in 500 mL NS during 3 h.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Combined Modality Therapy. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antimetabolites, Antineoplastic / therapeutic use. Antineoplastic Agents / therapeutic use. Antineoplastic Agents, Phytogenic / therapeutic use. Cisplatin / therapeutic use. Dose Fractionation. Female. Fluorouracil / therapeutic use. Humans. Male. Middle Aged. Paclitaxel / therapeutic use. Time Factors. Treatment Outcome

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  • (PMID = 12095561.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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82. Kang SY, Oh YT, Han JH, Choi JH, Lim HY, Kim HI, Lee HW, Jang JH, Park JS, Kim HC, Kang S, Chun M, Kim CH, Joo HJ: Concurrent chemoradiotherapy in patients with nasopharyngeal cancer: prognostic significance of low expression of bax. Neoplasma; 2006;53(5):450-6
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  • [Title] Concurrent chemoradiotherapy in patients with nasopharyngeal cancer: prognostic significance of low expression of bax.
  • A randomized trial has demonstrated that concurrent chemoradiotherapy (CRT) is superior to radiotherapy (RT) alone in locally advanced nasopharyngeal cancer (NPC).
  • Our study comprise 35 patients with locally advanced NPC (stage I: 1, II: 12, III: 7, IV: 15) with 1 cycle of induction chemotherapy (5-fluorouracil 1,000 mg/m(2)/day and cisplatin 20 mg/m(2)/day, days 1- 4) followed by concurrent CRT starting on day 22.
  • Concurrent CRT consisted of RT (70 Gy/35 fractions for 7 weeks) with cisplatin 20 mg/m(2)/day for 4 days on weeks 1, 4, 7 of RT.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. bcl-2-Associated X Protein / biosynthesis
  • [MeSH-minor] Adult. Biomarkers, Tumor / analysis. Cisplatin / therapeutic use. Combined Modality Therapy. Female. Fluorouracil / therapeutic use. Humans. Male. Middle Aged. Prognosis. Survival Analysis

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  • (PMID = 17013542.001).
  • [ISSN] 0028-2685
  • [Journal-full-title] Neoplasma
  • [ISO-abbreviation] Neoplasma
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Slovakia
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / bcl-2-Associated X Protein; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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83. Benasso M, Sanguineti G, D'Amico M, Corvò R, Ricci I, Numico G, Guarneri D, Vitale V, Pallestrini E, Santelli A, Rosso R: Induction chemotherapy followed by alternating chemo-radiotherapy in stage IV undifferentiated nasopharyngeal carcinoma. Br J Cancer; 2000 Dec;83(11):1437-42
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  • [Title] Induction chemotherapy followed by alternating chemo-radiotherapy in stage IV undifferentiated nasopharyngeal carcinoma.
  • In locally advanced undifferentiated nasopharyngeal carcinoma (UNPC), concomitant chemo-radiotherapy is the only strategy that gave better results over radiation alone in a phase III trial.
  • Adding effective chemotherapy to a concomitant chemo-radiotherapy programme may be a way to improve the results further.
  • 30 patients with previously untreated T4 and/or N2-3 undifferentiated nasopharyngeal carcinoma were consecutively enrolled and initially treated with 3 courses of epidoxorubicin, 90 mg/m2, day 1 and cisplatin, 40 mg/m2, days 1 and 2, every 3 weeks.
  • After a radiological and clinical response assessment patients underwent 3 courses of cisplatin, 20 mg/m2/day, days 1-4 and fluorouracil, 200 mg/m2/day, days 1-4, i.v. bolus, (weeks 1, 4, 7) alternated to 3 courses of radiation (week 2-3, 5-6, 8-9-10), with a single daily fractionation, up to 70 Gy.
  • WHO histology was type 2 in 30% and type 3 in 70% of the patients.
  • All but one received 3 courses of induction chemotherapy.
  • All the patients but one had the planned number of chemotherapy courses in the alternating phase and all received the planned radiation dose.
  • One patient out of 3 developed grade III-IV mucositis.
  • At a median follow-up of 31 months, 13.3% of patients had a loco-regional progression and 20% developed distant metastases.
  • Induction chemotherapy followed by alternating chemo-radiotherapy is feasible and patients' compliance optimal.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Disease-Free Survival. Drug Administration Schedule. Epirubicin / administration & dosage. Epirubicin / adverse effects. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Male. Middle Aged. Prospective Studies. Remission Induction. Survival Rate

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  • [Copyright] Copyright 2000 Cancer Research CampaignCopyright 2000 Cancer Research Campaign.
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  • (PMID = 11076650.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] SCOTLAND
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2363421
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84. Biel MA: Photodynamic therapy of head and neck cancers. Methods Mol Biol; 2010;635:281-93
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  • [Title] Photodynamic therapy of head and neck cancers.
  • The predominant histology is squamous cell carcinoma, but other histologies treated include mucosal melanoma, Kaposi's sarcoma, adenocarcinoma, metastatic breast carcinoma, and adenoid cystic carcinoma.
  • Several multi-institutional phase II clinical trials evaluating PDT treatment of head and neck cancers have demonstrated the efficacy of this minimally invasive therapy in the treatment of early oropharyngeal primary and recurrent cancers as well as the palliative treatment of refractory head and neck cancers.
  • Patients with early stage cancers or early recurrences in the oral cavity and larynx (Cis, T1, T2) tend to have an excellent response to PDT.
  • Of 518 patients treated with Cis, T1, or T2 cancers of the oral cavity, larynx, pharynx, and nasopharynx, 462 (89.1%) obtained a complete clinical response after one PDT treatment.
  • Photodynamic therapy is as effective as conventional therapies for the treatment of early (Cis, T1, T2) squamous cell cancers of the head and neck.
  • It is also a promising therapy to be used in association with surgery to increase tumor-free margins and therefore increase cure rates.
  • [MeSH-major] Head and Neck Neoplasms / drug therapy. Photochemotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Randomized Controlled Trials as Topic. Treatment Outcome. Young Adult

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  • (PMID = 20552353.001).
  • [ISSN] 1940-6029
  • [Journal-full-title] Methods in molecular biology (Clifton, N.J.)
  • [ISO-abbreviation] Methods Mol. Biol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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85. Hu W, Ding W, Yang H, Shao M, Wang B, Wang J, Wu S, Wu S, Jin L, Ma CC: Weekly paclitaxel with concurrent radiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma. Radiother Oncol; 2009 Dec;93(3):488-91
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  • [Title] Weekly paclitaxel with concurrent radiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma.
  • PURPOSE: To evaluate the efficacy and toxicity of weekly paclitaxel with concurrent radiotherapy followed by adjuvant chemotherapy (AC) in patients with locally advanced nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: Between 2004 and 2007, 54 patients with locally advanced NPC were included in this protocol.
  • PATIENT CHARACTERISTICS: median age 48; 69% male; 52% World Health Organization (WHO) III; 50% stage III, 50% stage IV.
  • The patients underwent a course of definitive conventional radiotherapy (70 Gy in 7 weeks with 2 Gy/fraction), with concurrent weekly paclitaxel 35 mg/m(2) from the first to the sixth week of radiation.
  • Eighty-five percentage of complete response and 15% partial response were achieved at the time of one month after AC.
  • Forty-nine (91%) patients completed six courses of concurrent chemotherapy with weekly paclitaxel, and 4 (7%) patients delayed at the second cycle of AC.
  • No patient developed severe acute toxicities.
  • CONCLUSIONS: Weekly paclitaxel with concurrent RT followed by AC is a potentially effective and toxicity tolerable method for locally advanced NPC.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Chemotherapy, Adjuvant. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Paclitaxel / administration & dosage
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Female. Humans. Male. Middle Aged. Radiotherapy Dosage. Radiotherapy, High-Energy

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  • (PMID = 19679366.001).
  • [ISSN] 1879-0887
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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86. Koutcher L, Lee N, Zelefsky M, Chan K, Cohen G, Pfister D, Kraus D, Wolden S: Reirradiation of locally recurrent nasopharynx cancer with external beam radiotherapy with or without brachytherapy. Int J Radiat Oncol Biol Phys; 2010 Jan 1;76(1):130-7
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  • [Title] Reirradiation of locally recurrent nasopharynx cancer with external beam radiotherapy with or without brachytherapy.
  • PURPOSE: To determine survival rates of patients with locally recurrent nasopharynx cancer (LRNPC) treated with modern therapeutic modalities.
  • Thirteen patients received combined-modality treatment (CMT), consisting of external beam radiotherapy (EBRT) followed by intracavitary brachytherapy, whereas 16 received EBRT alone.
  • Nine, 6, 8, and 6 patients had recurrent Stage I, II, III, and IV disease, respectively.
  • Median time to reirradiation was 3.9 years.
  • In total, 93% underwent imaging with positron emission tomography and/or magnetic resonance imaging before reirradiation, 83% received intensity-modulated radiotherapy, and 93% received chemotherapy, which was platinum-based in 85% of cases.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Neoplasm Recurrence, Local / radiotherapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Brachytherapy / adverse effects. Brachytherapy / methods. Cisplatin / therapeutic use. Combined Modality Therapy / methods. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiation Injuries / etiology. Radiation Injuries / pathology. Radiotherapy Dosage. Radiotherapy, Intensity-Modulated / adverse effects. Retreatment / methods. Survival Rate. Time Factors

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  • (PMID = 19467802.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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87. Varan A, Ozyar E, Corapçioğlu F, Köksal Y, Aydin B, Yazici N, Akyüz C, Büyükpamukçu M: Pediatric and young adult nasopharyngeal carcinoma patients treated with preradiation Cisplatin and docetaxel chemotherapy. Int J Radiat Oncol Biol Phys; 2009 Mar 15;73(4):1116-20
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  • [Title] Pediatric and young adult nasopharyngeal carcinoma patients treated with preradiation Cisplatin and docetaxel chemotherapy.
  • PURPOSE: To evaluate treatment results for pediatric and young adult (aged <21 years) patients with nonmetastatic nasopharyngeal carcinoma treated with neoadjuvant cisplatin + docetaxel and radiotherapy.
  • METHODS AND MATERIALS: Ten patients with nasopharyngeal carcinoma who received diagnoses between 2004 and 2007 were treated with four cycles of cisplatin 100 mg/m(2) + docetaxel 75 mg/m(2) on Day 1 with premedication every 3 weeks.
  • All patients were treated with fractionated external beam radiotherapy after chemotherapy to a median dose of 59.4 Gy (range, 54-59.4 Gy) to the primary disease and 40 Gy to the supraclavicular field with the clavicles shielded.
  • Five children were monitored with serum EBV DNA quantification at diagnosis, after each cycle of chemotherapy, before radiotherapy, and at follow-up.
  • Stage distribution was as follows: 2 patients had Stage IIb disease, 2 had Stage III, 4 had Stage IVa, and 2 had Stage IVb disease.
  • After cisplatin+docetaxel chemotherapy 1 patient had a complete response, 5 had a partial response, 3 had stable disease, and 1 had disease progression.
  • The 2-year overall survival rate in our series was 90% and the event-free survival rate was 70%.
  • No major chemotherapy toxicity was observed.
  • The EBV DNA titers were higher in 2 of the 5 monitored patients at the time of diagnosis.
  • CONCLUSION: As neoadjuvant chemotherapy before radiotherapy, the cisplatin+docetaxel combination is safe for use in the treatment of childhood nasopharyngeal carcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Neoadjuvant Therapy / methods. Taxoids / administration & dosage
  • [MeSH-minor] Adolescent. Child. Cisplatin / administration & dosage. DNA, Viral / isolation & purification. Drug Administration Schedule. Female. Herpesvirus 4, Human / genetics. Humans. Male. Neoplasm Staging. Retrospective Studies. Survival Analysis. Young Adult

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  • (PMID = 18786778.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Viral; 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin
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88. Haimi M, Arush MW, Bar-Sela G, Gez E, Bernstein Z, Postovsky S, Barak AB, Kuten A: Nasopharyngeal carcinoma in the pediatric age group: the northern Israel (Rambam) medical center experience, 1989-2004. J Pediatr Hematol Oncol; 2005 Oct;27(10):510-6
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  • [Title] Nasopharyngeal carcinoma in the pediatric age group: the northern Israel (Rambam) medical center experience, 1989-2004.
  • Nasopharyngeal carcinoma (NPC) is rare in children, accounting for less than 1% of all malignancies.
  • Radiation therapy has been the mainstay of treatment of many years, but to improve survival, the use of chemotherapy has been advocated.
  • This is a retrospective analysis of 13 patients less than 20 years of age treated for NPC the Rambam Medical Center during 1989 to 2004.
  • Of the 13 patients, one patient had stage I, 6 had stage III, 5 had stage IV-A, and 1 had stage IV-B disease.
  • Ten patients (77%) had undifferentiated carcinoma (WHO type III) and three patients (23%) had nonkeratinizing carcinoma (WHO type II).
  • Most of the children received two or three courses of neoadjuvant multiagent chemotherapy consisting of cisplatin and 5-FU, followed by radiotherapy with doses in excess of 60 Gy.
  • Ten of the 13 patients (77%) are alive without disease 6 years after diagnosis (range 1-15 years).
  • One patient developed local and distant metastases 1 year after diagnosis and is currently receiving combined radiochemotherapy.
  • Nine patients (69%) developed moderate to severe long-term complications.
  • Pediatric NPC is curable by combined radiation and chemotherapy, with doses of radiation in excess of 60 Gy.
  • Long-term follow-up is important for early detection of second malignancies as well as for radiation-induced endocrinologic deficiencies and other normal tissue complications.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / therapy. Neoadjuvant Therapy
  • [MeSH-minor] Adolescent. Age Distribution. Carcinoma / epidemiology. Carcinoma / therapy. Carcinoma, Squamous Cell / epidemiology. Carcinoma, Squamous Cell / therapy. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Infant. Israel / epidemiology. Male. Prognosis. Radiotherapy Dosage. Retrospective Studies. Survival Rate. Vinblastine / administration & dosage

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  • (PMID = 16217252.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; U3P01618RT / Fluorouracil
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89. Lee N, Hoffman R, Phillips TL, Xia P, Quivey JM, Weinberg V, Hsu IC: Managing nasopharyngeal carcinoma with intracavitary brachytherapy: one institution's 45-year experience. Brachytherapy; 2002;1(2):74-82
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  • [Title] Managing nasopharyngeal carcinoma with intracavitary brachytherapy: one institution's 45-year experience.
  • PURPOSE: At our institution, we have been using intracavitary brachytherapy as a boost in selected cases of both primary and recurrent nasopharyngeal carcinoma.
  • METHODS AND MATERIALS: Between January 1, 1955, and August 2000, 576 patients with a diagnosis of nasopharyngeal carcinoma were seen at the department of radiation oncology, University of California-San Francisco, and 55 patients received intracavitary brachytherapy as one part of their treatment.
  • Stage at treatment (primary and recurrent) was I (n=13), II (n=18), III (n=19), and IV (n=5); 18 patients had concurrent chemotherapy.
  • External beam doses ranged from 54 to 72 Gy for primary disease and 30 to 42 Gy for recurrent disease.
  • Brachytherapy doses ranged from 5 to 7 Gy for high dose rate and 10 to 54 Gy for low dose rate.
  • RESULTS: With a median follow-up of 36 months in those who were treated for primary carcinoma, the 5-year estimate of local control was 89%, the distant metastasis-free rate was 75%, and the overall survival estimate was 86%.
  • Patients with Stage I or II disease had a longer overall survival compared with those with Stage III or IV (p=0.05).
  • There was a significant difference in the rate of distant metastases due to nodal status (N0 vs. N1-N3, p=0.02) or to overall stage (I/II vs. III/IV, p=0.005).
  • CONCLUSIONS: Intracavitary boost brachytherapy was found to be effective and well tolerated in selected cases of both primary and recurrent nasopharyngeal carcinoma.
  • [MeSH-major] Brachytherapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Prognosis. Survival Rate. Time Factors

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  • (PMID = 15062174.001).
  • [ISSN] 1538-4721
  • [Journal-full-title] Brachytherapy
  • [ISO-abbreviation] Brachytherapy
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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90. Rischin D, Corry J, Smith J, Stewart J, Hughes P, Peters L: Excellent disease control and survival in patients with advanced nasopharyngeal cancer treated with chemoradiation. J Clin Oncol; 2002 Apr 1;20(7):1845-52
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  • [Title] Excellent disease control and survival in patients with advanced nasopharyngeal cancer treated with chemoradiation.
  • PURPOSE: To determine the efficacy and safety of epirubicin, cisplatin, and infusional fluorouracil (5-FU) chemotherapy followed by radiation with concurrent cisplatin in patients with locally and/or regionally advanced nasopharyngeal cancer.
  • PATIENTS AND METHODS: Thirty-five patients were treated with three cycles of induction chemotherapy with epirubicin 50 mg/m(2) and cisplatin 75 mg/m(2) combined with continuous-infusion 5-FU 200 mg/m(2) daily for 9 weeks, followed by concurrent chemoradiation of 60 Gy in 2-Gy fractions with cisplatin 20 mg/m(2) daily for 5 days in weeks 1 and 6.
  • RESULTS: Median age was 43 years, 74% had World Health Organization type III histology, and 91% had stage IV disease (International Union Against Cancer, ed 4).
  • All patients received three cycles of induction chemotherapy, and 97% completed chemoradiation.
  • Only two patients have had a locoregional relapse by the close-out date despite the use of only 60 Gy.
  • Induction chemotherapy was well tolerated, with 11% grade 3 or 4 stomatitis, 26% grade 3 vomiting, and no episodes of febrile neutropenia.
  • CONCLUSION: This regimen was well tolerated, can be delivered as planned, and has resulted in excellent locoregional disease control and survival in patients with locally advanced nasopharyngeal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Antibiotics, Antineoplastic / administration & dosage. Antimetabolites, Antineoplastic / administration & dosage. Chemotherapy, Adjuvant / adverse effects. Cisplatin / administration & dosage. Disease-Free Survival. Drug Administration Schedule. Epirubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Remission Induction. Survival Analysis. Treatment Outcome

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  • (PMID = 11919243.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antimetabolites, Antineoplastic; 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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91. Wong FC, Ng AW, Lee VH, Lui CM, Yuen KK, Sze WK, Leung TW, Tung SY: Whole-field simultaneous integrated-boost intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2010 Jan 1;76(1):138-45
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  • [Title] Whole-field simultaneous integrated-boost intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma.
  • PURPOSE: To retrospectively review the outcomes of our patients with newly diagnosed nondisseminated nasopharyngeal carcinoma treated with intensity-modulated radiotherapy using a whole-field simultaneous integrated-boost technique.
  • The distribution of disease by stage was Stage IA in 10.9%, Stage IIA in 2.3%, Stage IIB in 21.7%, Stage III in 41.1%, Stage IVA in 14.9%, and Stage IVB in 9.1%.
  • Of the 175 patients, 2 (1.2%), 10 (5.7%), and 163 (93.1%) had World Health Organization type I, II, and III histologic features, respectively.
  • We prescribed 70 Gy, 60 Gy, and 54 Gy delivered in 33 fractions within 6.5 weeks at the periphery of three planning target volumes (PTV; PTV70, PTV60, and PTV54, respectively).
  • Of the 175 patients, 46 with early T-stage disease received a brachytherapy boost, and 127 with advanced local or regional disease received chemotherapy.
  • Cox regression analysis showed Stage N2-N3 disease (p = .029) and PTV (p = .024) to be independent factors predicting a greater risk of distant failure and poor overall survival, respectively.
  • Grade 3 acute mucositis/pharyngitis occurred in 23.4% of patients, and Stage T4 disease was the only significant predictor of mucositis/pharyngitis (p = .021).
  • CONCLUSION: Whole-field simultaneous integrated-boost intensity-modulated radiotherapy with a dose >70 Gy achieved excellent locoregional control, without an excess incidence of severe, acute mucositis/pharyngitis, in the present study.
  • Strategies for using such highly conformal treatment for patients with a large tumor and late N-stage disease are potential areas of investigation for future studies.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brachytherapy / methods. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Mucositis / etiology. Neoplasm Staging. Pharyngitis / etiology. Radiotherapy Dosage. Regression Analysis. Remission Induction. Retrospective Studies. Treatment Outcome. Tumor Burden. Young Adult

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  • (PMID = 19646824.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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92. Pedersen MØ, Larsen A, Stoltenberg M, Penkowa M: The role of metallothionein in oncogenesis and cancer prognosis. Prog Histochem Cytochem; 2009;44(1):29-64
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  • [Title] The role of metallothionein in oncogenesis and cancer prognosis.
  • The antiapoptotic, antioxidant, proliferative, and angiogenic effects of metallothionein (MT)-I+II has resulted in increased focus on their role in oncogenesis, tumor progression, therapy response, and patient prognosis.
  • Studies have reported increased expression of MT-I+II mRNA and protein in various human cancers; such as breast, kidney, lung, nasopharynx, ovary, prostate, salivary gland, testes, urinary bladder, cervical, endometrial, skin carcinoma, melanoma, acute lymphoblastic leukemia (ALL), and pancreatic cancers, where MT-I+II expression is sometimes correlated to higher tumor grade/stage, chemotherapy/radiation resistance, and poor prognosis.
  • However, MT-I+II are downregulated in other types of tumors (e.g. hepatocellular, gastric, colorectal, central nervous system (CNS), and thyroid cancers) where MT-I+II is either inversely correlated or unrelated to mortality.
  • Large discrepancies exist between different tumor types, and no distinct and reliable association exists between MT-I+II expression in tumor tissues and prognosis and therapy resistance.
  • Furthermore, a parallel has been drawn between MT-I+II expression as a potential marker for prognosis, and MT-I+II's role as oncogenic factors, without any direct evidence supporting such a parallel.
  • This review aims at discussing the role of MT-I+II both as a prognostic marker for survival and therapy response, as well as for the hypothesized role of MT-I+II as causal oncogenes.
  • [MeSH-major] Biomarkers, Tumor. Metallothionein / physiology. Neoplasms / diagnosis. Neoplasms / physiopathology

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  • (PMID = 19348910.001).
  • [ISSN] 0079-6336
  • [Journal-full-title] Progress in histochemistry and cytochemistry
  • [ISO-abbreviation] Prog Histochem Cytochem
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 9038-94-2 / Metallothionein
  • [Number-of-references] 203
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93. Al-Amro A, Al-Rajhi N, Khafaga Y, Memon M, Al-Hebshi A, El-Enbabi A, El-Husseiny G, Radawi A, Belal A, Allam A, El-Sebaie M: Neoadjuvant chemotherapy followed by concurrent chemo-radiation therapy in locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2005 Jun 1;62(2):508-13
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  • [Title] Neoadjuvant chemotherapy followed by concurrent chemo-radiation therapy in locally advanced nasopharyngeal carcinoma.
  • PURPOSE: To evaluate the efficacy and outcomes of neoadjuvant cisplatinum and epirubicin chemotherapy followed by concurrent cisplatinum chemotherapy with radiotherapy in patients with locally advanced nasopharyngeal carcinoma.
  • METHODS AND MATERIALS: One hundred ten patients (80 male, 30 female) with locally advanced nasopharyngeal carcinoma, staged according to the 1997 International Union Against Cancer/American Joint Committee on Cancer classification system as IIB (n = 9), III (n = 20), IVA (n = 32), and IVB (n = 49), World Health Organization types II (n = 25) and III (n = 85), were included in this protocol between January 1998 and July 2000 at King Faisal Specialist Hospital and Research Centre.
  • Patients underwent two cycles of induction chemotherapy with cisplatinum 100 mg/m(2) and epirubicin 70 mg/m(2) on Days 1 and 21, followed by a radical course of radiotherapy (6,600 cGy in 6.5 weeks, 200 cGy/fraction) starting on Day 42, with three cycles of concurrent cisplatinum 25 mg/m(2) for 4 days on Days 42, 63, and 84.
  • RESULTS: Of 110 patients included in this study, intracranial extension was present in 32 (29%), and nodal stage was N3 in 49 (45%).
  • At a median follow-up for surviving patients of 37 months (22-55 months), 49 of 110 patients (44%) had failed treatment: 12 with local, 9 with regional nodes, 4 locoregional, 5 locoregional plus distant areas, and 19 with distant metastases.
  • At the time of writing, 34 patients had died; all deaths were related to the patients' cancer except for 1 patient with treatment-related toxicity.
  • Three-year actuarial overall survival, relapse-free survival, locoregional control, and distant metastasis-free survival rates were 89%, 78%, 88%, and 89% for patients with stage IIB; 71%, 70%, 89%, and 74% for stage III; 68%, 49%, 61%, and 77% for stage IVA; and 70%, 45%, 60%, and 69% for stage IVB, respectively.
  • One patient received only one induction cycle; all others received two cycles; however, 9 of them required 20% reduction in the second cycle dose.
  • Rates of Grade 3 and 4 reactions after induction chemotherapy were as follows: anemia 1% and 0%, leukopenia 8% and 4%, nausea 27% and 0%, vomiting 25% and 0%, and infection 4% and 4%, respectively.
  • CONCLUSIONS: Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy is a safe and effective method of treatment for locally advanced nasopharyngeal carcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Epirubicin / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Staging. Remission Induction. Treatment Failure

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  • (PMID = 15890594.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin
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94. Tao ZQ, Liu SC, Si YF, Zhang Z, Zhou XZ, Deng ZX, Zhou RJ, Huang B: [Relationship between expression of multidrug-resistant genes in nasopharyngeal carcinoma tissue and sensitivity to chemotherapy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2005 Mar;40(3):203-7
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  • [Title] [Relationship between expression of multidrug-resistant genes in nasopharyngeal carcinoma tissue and sensitivity to chemotherapy].
  • OBJECTIVE: To study the relationship between multidrug-resistant (MDR) expression in nasopharyngeal carcinoma (NPC) and its sensitivity to chemotherapy.
  • METHODS: The specimens of 23 NPC cases were studied by immunohistochemistry with monoclonal antibody of P-glycoprotein (P-gp), multidrug resistance relation protein (MRP), lung-resistance related protein (LRP), topoisomerase II (Topo II), thymidylate synthase (TS), glutathione-S-transferase (GST-pi).
  • Among them, 20 specimens were taken from primary NPC lesion which were treated with two course of cisplatin (DDP) and 5-fluorouracil (5-FU), 3 specimens were taken from cervical lymph-node of recurrent NPC patients who were treated by radical dissection.
  • RESULTS: Various MDR parameters were expressed differently in 22 cases except for 1 clear cell carcinoma case.
  • However, there were no significant difference of MDR expression either among various carcinoma pathomorphology cell groups or among different clinical stage groups.
  • Expression of LRP and TS were found in 10 and 14 cases respectively and the chemotherapy responders rates were 20% (2/10) and 28.5% (4/14) respectively.
  • While the chemotherapy responders rates were 70% (7/10) and 5/6 in cases without expression.
  • CONCLUSION: The NPC patients with LRP and TS expression may be less sensitive to chemotherapy with DDP + 5-FU.
  • [MeSH-major] Drug Resistance, Multiple / genetics. Drug Resistance, Neoplasm / genetics. Nasopharyngeal Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / pharmacology. Cisplatin / therapeutic use. Drug Screening Assays, Antitumor. Female. Fluorouracil / pharmacology. Fluorouracil / therapeutic use. Glutathione S-Transferase pi / genetics. Humans. Male. Middle Aged. P-Glycoprotein / genetics. Thymidylate Synthase / genetics. Vault Ribonucleoprotein Particles / genetics

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  • (PMID = 15952572.001).
  • [ISSN] 1673-0860
  • [Journal-full-title] Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / P-Glycoprotein; 0 / Vault Ribonucleoprotein Particles; 0 / major vault protein; EC 2.1.1.45 / Thymidylate Synthase; EC 2.5.1.18 / Glutathione S-Transferase pi; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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95. Haddad R, Colevas AD, Tishler R, Busse P, Goguen L, Sullivan C, Norris CM, Lake-Willcutt B, Case MA, Costello R, Posner M: Docetaxel, cisplatin, and 5-fluorouracil-based induction chemotherapy in patients with locally advanced squamous cell carcinoma of the head and neck: the Dana Farber Cancer Institute experience. Cancer; 2003 Jan 15;97(2):412-8
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  • [Title] Docetaxel, cisplatin, and 5-fluorouracil-based induction chemotherapy in patients with locally advanced squamous cell carcinoma of the head and neck: the Dana Farber Cancer Institute experience.
  • BACKGROUND: The authors conducted a series of four Phase I-II trials of high-dose and intermediate-dose docetaxel, cisplatin, and 5-fluorouracil (TPF)-based induction chemotherapy for patients with advanced squamous cell carcinoma of the head and neck (SCCHN).
  • The chemotherapy regimens and response rates for each trial were published previously.
  • Overall, 68 patients (67%) had N2-N3 disease, and 86 patients (85%) had Stage IV disease.
  • Excluding 17 patients with nasopharyngeal carcinoma, of 84 patients, 55 patients remain alive with NED (65%).
  • Significant morbidity was low, with two treatment-related deaths.
  • Given the increase in local-regional dose intensity with chemoradiation, sequential treatment plans that integrate induction chemotherapy and chemoradiotherapy seem to be the logical next step.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Head and Neck Neoplasms / drug therapy. Paclitaxel / analogs & derivatives. Taxoids
  • [MeSH-minor] Cisplatin / administration & dosage. Clinical Trials, Phase I as Topic. Clinical Trials, Phase II as Topic. Dose Fractionation. Fluorouracil / administration & dosage. Follow-Up Studies. Granulocyte Colony-Stimulating Factor / administration & dosage. Humans. Leucovorin / administration & dosage. Radiotherapy, Adjuvant. Survival Analysis. Treatment Failure. Treatment Outcome

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  • [Copyright] Copyright 2003 American Cancer Society
  • (PMID = 12518365.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Taxoids; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 15H5577CQD / docetaxel; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; TPFL4 regimen; TPFL5 protocol; opTPFL regimen
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96. Fischer M, Stüben G, Klahold M, Stuschke M, Budach V, Sack H, Jahnke K: Accelerated hyperfractionated radiotherapy with concurrent chemotherapy in locally advanced nasopharyngeal carcinoma: a phase II study. J Cancer Res Clin Oncol; 2001 Aug;127(8):507-11
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  • [Title] Accelerated hyperfractionated radiotherapy with concurrent chemotherapy in locally advanced nasopharyngeal carcinoma: a phase II study.
  • PURPOSE: The incidence of nasopharyngeal carcinoma in Germany is relatively low in comparison with certain regions in south-east Asia.
  • However, standardised therapeutical regimes are required in the treatment of these tumours.
  • METHODS: Between August 1990 and December 1997, 25 patients with stage III and IV nasopharyngeal carcinoma received an accelerated and hyperfractionated radiotherapy with concurrent chemotherapy (5-FU and mitomycin C).
  • The primary tumour and positive lymph nodes received a total dose of 72 Gy over a period of 6 weeks.
  • In the first 3 weeks, irradiation fields were treated five times per week with 2 Gy per fraction.
  • Thereafter, treatment was accelerated, giving two daily fractions of 1.4 Gy.
  • CONCLUSIONS: The presented data are promising and show that the combination of hyperfractionated accelerated radiotherapy and chemotherapy is feasible and effective.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Dose Fractionation. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Male. Middle Aged. Mitomycin / administration & dosage. Neoplasm Staging. Radiotherapy, Adjuvant. Salvage Therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 11501751.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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97. Wolden SL, Zelefsky MJ, Hunt MA, Rosenzweig KE, Chong LM, Kraus DH, Pfister DG, Leibel SA: Failure of a 3D conformal boost to improve radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2001 Apr 1;49(5):1229-34
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  • [Title] Failure of a 3D conformal boost to improve radiotherapy for nasopharyngeal carcinoma.
  • PURPOSE: To determine whether the use of 3-dimensional (3D) boost for patients with nasopharynx cancer improves local control and reduces the risk of long-term complications.
  • METHODS AND MATERIALS: From 1988 to 1998, 68 patients with nasopharynx cancer received conventional external beam therapy followed by a 3D boost.
  • Disease characteristics of treated patients were as follows: WHO I histology 7%, WHO II 62%, WHO III 31%, clinical AJCC stage T1--2 45%, T3--4 55%, N0--1 63%, N2--3 37%, M0 100%.
  • The median radiation dose was 70 Gy (68--75.6 Gy).
  • Thirty-five patients (52%) received cisplatin-based chemotherapy.
  • Stage was the only identifiable prognostic factor: 5-year progression-free survival was 65% for Stages I--III vs. 40% for Stage IV (p = 0.01).
  • We are now using intensity modulated radiation therapy to deliver the entire course of radiation.
  • Intensity modulated radiation therapy achieves better conformal distributions than conventional 3D planning, allowing dose escalation and increased normal tissue sparing.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Conformal
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Survival Analysis. Treatment Failure

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  • (PMID = 11286827.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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98. Elser C, Siu LL, Winquist E, Agulnik M, Pond GR, Chin SF, Francis P, Cheiken R, Elting J, McNabola A, Wilkie D, Petrenciuc O, Chen EX: Phase II trial of sorafenib in patients with recurrent or metastatic squamous cell carcinoma of the head and neck or nasopharyngeal carcinoma. J Clin Oncol; 2007 Aug 20;25(24):3766-73
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  • [Title] Phase II trial of sorafenib in patients with recurrent or metastatic squamous cell carcinoma of the head and neck or nasopharyngeal carcinoma.
  • PURPOSE: To determine the efficacy and safety of single-agent sorafenib in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN) and nasopharyngeal carcinoma (NPC).
  • PATIENTS AND METHODS: In this single-arm phase II trial, oral continuous sorafenib was administered in 28-day cycles.
  • Patients had <or= one line of chemotherapy for recurrent and/or metastatic disease, Eastern Cooperative Oncology Group performance status of <or= 2, and adequate organ function.
  • At the end of stage 1, efficacy criteria for further accrual were not met, but the study was amended to enroll an additional five patients for paired tumor biopsies.
  • The median time to progression was 1.8 months (95% CI, 1.6 to 3.4 months), and median overall survival time was 4.2 months (95% CI, 3.6 to 8.7 months).
  • Biomarker analysis of paired tumor samples before and after treatment with sorafenib revealed a decrease of pERK in all five patients, with a decrease in Ki67 in four patients, consistent with a disruption of ERK signaling.
  • The antiapoptotic protein Mcl-1 was downregulated in four patients, and there was also evidence of antiangiogenic activity.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Benzenesulfonates / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Head and Neck Neoplasms / drug therapy. Nasopharyngeal Neoplasms / drug therapy. Pyridines / therapeutic use
  • [MeSH-minor] Adult. Aged. Disease Progression. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Niacinamide / analogs & derivatives. Phenylurea Compounds. Protein Kinase Inhibitors / therapeutic use. Survival Rate. raf Kinases / antagonists & inhibitors


99. Khademi B, Mahmoodi J, Omidvari S, Mohammadianpanah M: Treatment results of nasopharyngeal carcinoma: a 15-year single institutional experience. J Egypt Natl Canc Inst; 2006 Jun;18(2):147-55
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  • [Title] Treatment results of nasopharyngeal carcinoma: a 15-year single institutional experience.
  • BACKGROUND: Nasopharyngeal Carcinoma (NPC) is a common malignant neoplasm of the head and neck that occurs most commonly in people in the South Eastern Asia but its condition in Iran is not much clear.
  • OBJECTIVE: In this retrospective study, we evaluated the treatment characteristics determining the outcome in patients with NPC.
  • PATIENTS AND METHODS: In this retrospective study, we reviewed the records of one hundred and seven patients with biopsy proven diagnosis of NPC who were referred to the radiation oncology department, Nemazee Hospital, Shiraz University of Medical Sciences, Iran, during the time period from January 1985 to December 2000.
  • Sixty-two patients (57.5%) received radiotherapy combined with adjuvant chemotherapy which consisted of cisplatin and 5-fluorouracil.
  • Eighty-six patients (80.4%) had WHO II-III histopathologic diagnosis.
  • According to the AJCC 1997 staging system, 4 (3.6%), 3 (2.7%), 33 (30.8%) and 67 (62%) patients were in stages I, II, III and IV, respectively.
  • RESULTS: With a median follow-up of 12 months, the 2-year overall and disease-free survival rates were 35% and 21%, respectively.
  • Node stage and stage of disease were significant prognostic factors (p=0.0001).
  • On multivariate analysis for disease-free survival, age and node stage were significant prognostic factors.
  • The patients who received more than 60Gy radiation had a better prognosis (p=0.02), however; sequential adjuvant chemotherapy had no impact on survival and response (p=0.6).
  • CONCLUSION: Our experience confirmed earlier reports showing poor outcomes for locoregionally advanced nasopharyngeal carcinomas.
  • This study failed to demonstrate improvement in the outcome regarding overall and disease-free survival by adding sequential adjuvant chemotherapy after radiotherapy for patients with advanced NPC.
  • [MeSH-major] Nasopharyngeal Neoplasms / mortality. Nasopharyngeal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Humans. Male. Middle Aged. Survival Analysis. Treatment Outcome

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  • (PMID = 17496940.001).
  • [ISSN] 1110-0362
  • [Journal-full-title] Journal of the Egyptian National Cancer Institute
  • [ISO-abbreviation] J Egypt Natl Canc Inst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
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100. Ho JC, Wong MP, Lam WK: Lymphoepithelioma-like carcinoma of the lung. Respirology; 2006 Sep;11(5):539-45
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  • [Title] Lymphoepithelioma-like carcinoma of the lung.
  • Lymphoepithelioma-like carcinoma (LELC) of the lung was first reported in 1987.
  • This uncommon but distinct form of non-small cell lung carcinoma has a predilection for young non-smoking Asians, without gender distinction.
  • Histologically, it is indistinguishable from undifferentiated nasopharyngeal carcinoma.
  • Among the reported cases, more than half were in early resectable stages (I or II) and there was a tendency for peribronchovascular spread with vascular encasement in advanced diseases.
  • In order to establish the diagnosis of LELC of the lung, both nasopharyngeal carcinoma and lymphoma have to be excluded by endoscopic biopsy (with or without magnetic resonance imaging of the nasopharynx) and immunohistochemical staining of the biopsy samples.
  • The mainstay of treatment for early-stage disease is curative surgical resection, whereas multimodality treatment (surgery, chemotherapy, radiotherapy) has been adopted in advanced or metastatic diseases.
  • The overall survival is more favourable in LELC of the lung compared with non-LELC type of non-small cell lung carcinoma.
  • Future collaborative studies especially on optimizing treatment for this uncommon malignancy are clearly warranted.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / diagnosis. Lung / pathology. Lung Neoplasms / diagnosis

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  • (PMID = 16916325.001).
  • [ISSN] 1323-7799
  • [Journal-full-title] Respirology (Carlton, Vic.)
  • [ISO-abbreviation] Respirology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Australia
  • [Number-of-references] 40
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