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1. Chan DB, Ong CK, Soo RL: Subdural empyema post-chemoradiotherapy for nasopharyngeal carcinoma. Singapore Med J; 2006 Dec;47(12):1089-91
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  • [Title] Subdural empyema post-chemoradiotherapy for nasopharyngeal carcinoma.
  • Nasopharyngeal carcinoma is a common malignancy in the Asian Chinese population.
  • The first-line treatment for Stage III/IV disease has in recent times shifted from radiotherapy to that of concurrent chemoradiotherapy.
  • The treatment is not infrequently associated with in-field complications.
  • We describe a rare case of one such complication -- subdural empyema developing post-chemoradiotherapy in a 56-year-old man with Stage IVB nasopharyngeal carcinoma.
  • [MeSH-minor] Carcinoma / drug therapy. Carcinoma / radiotherapy. Fatal Outcome. Humans. Klebsiella Infections / blood. Klebsiella Infections / drug therapy. Klebsiella Infections / urine. Klebsiella pneumoniae / pathogenicity. Male. Middle Aged. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy

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  • (PMID = 17139409.001).
  • [ISSN] 0037-5675
  • [Journal-full-title] Singapore medical journal
  • [ISO-abbreviation] Singapore Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Singapore
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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2. Thiagarajan A, Lin K, Tiong CE, Tan LK, Loh TK, Goh BC, Lu JJ: Sequential external beam radiotherapy and high-dose-rate intracavitary brachytherapy in T1 and T2 nasopharyngeal carcinoma: an evaluation of long-term outcome. Laryngoscope; 2006 Jun;116(6):938-43
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  • [Title] Sequential external beam radiotherapy and high-dose-rate intracavitary brachytherapy in T1 and T2 nasopharyngeal carcinoma: an evaluation of long-term outcome.
  • OBJECTIVES/HYPOTHESIS: The standard treatment for nonmetastatic nasopharyngeal carcinoma (NPC) is external beam radiotherapy (EBRT), with or without chemotherapy.
  • Because local control in NPC is an independent prognostic factor for distant metastases and survival, various dose-escalation strategies have been used to reduce recurrences at the primary site.
  • The objective of this report was to evaluate the outcome of adjuvant high-dose-rate intracavitary brachytherapy (HDRIB) in patients with T1 and T2 NPC.
  • STUDY DESIGN AND METHODS: Thirty-three consecutive patients with T1 and T2 NPC were treated prospectively according to a standardized institutional protocol between March 1999 and July 2001.
  • Seventeen patients with stage I/II disease were treated with EBRT to 66 Gy followed by HDRIB (10 Gy in 2 weekly 5 Gy fractions).
  • The remaining 16 patients with Stage III to IVb disease received chemotherapy in addition to radiation.
  • All patients were assessed for treatment response, local control, survival, and toxicity.
  • Local failure occurred in two patients; both subsequently underwent successful salvage treatments.
  • Specifically, toxicities that could be attributed to brachytherapy were not seen, except for in one patient who developed severe choanal stenosis.
  • CONCLUSIONS: EBRT supplemented by HDRIB produced superior local control rates for T1 and T2 NPC at 5 years of follow-up, with acceptable rates of acute and late toxicities.
  • [MeSH-major] Brachytherapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiotherapy / adverse effects. Radiotherapy / methods. Radiotherapy, Adjuvant. Salvage Therapy. Survival Rate. Treatment Outcome

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  • (PMID = 16735885.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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3. Chua DT, Ma J, Sham JS, Mai HQ, Choy DT, Hong MH, Lu TX, Min HQ: Long-term survival after cisplatin-based induction chemotherapy and radiotherapy for nasopharyngeal carcinoma: a pooled data analysis of two phase III trials. J Clin Oncol; 2005 Feb 20;23(6):1118-24
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  • [Title] Long-term survival after cisplatin-based induction chemotherapy and radiotherapy for nasopharyngeal carcinoma: a pooled data analysis of two phase III trials.
  • PURPOSE: To evaluate the long-term outcome in patients with nasopharyngeal carcinoma (NPC) treated with induction chemotherapy and radiotherapy (CRT) versus radiotherapy alone (RT).
  • PATIENTS AND METHODS: The data from two phase III studies comparing CRT with RT in NPC were updated and pooled together for analysis.
  • Induction chemotherapy consisted of two to three cycles of cisplatin, bleomycin, and fluorouracil, or cisplatin and epirubicin.
  • RT was given to the nasopharynx and neck using megavoltage radiation (median dose, 70 Gy).
  • The median follow-up time for surviving patients was 67 months.
  • RESULTS: The addition of induction chemotherapy to RT was associated with a decrease in relapse by 14.3% and cancer-related deaths by 12.9% at 5 years.
  • The incidence of locoregional failure and distant metastases was reduced by 18.3% and 13.3% at 5 years, respectively, with induction chemotherapy.
  • There was no significant difference in the treatment failure patterns between the two arms.
  • CONCLUSION: The addition of cisplatin-based induction chemotherapy to RT was associated with a modest but significant decrease in relapse and improvement in disease-specific survival in advanced-stage NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Metastasis. Neoplasm Recurrence, Local. Radiotherapy, High-Energy. Remission Induction. Survival Analysis

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  • [CommentIn] J Clin Oncol. 2005 Feb 20;23(6):1059-60 [15657407.001]
  • (PMID = 15657403.001).
  • [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] Comparative Study; Journal Article; Meta-Analysis
  • [Publication-country] United States
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4. Kwong DL, Sham JS, Leung LH, Cheng AC, Ng WM, Kwong PW, Lui WM, Yau CC, Wu PM, Wei W, Au G: Preliminary results of radiation dose escalation for locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2006 Feb 1;64(2):374-81
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  • [Title] Preliminary results of radiation dose escalation for locally advanced nasopharyngeal carcinoma.
  • PURPOSE: To study the safety and efficacy of dose escalation in tumor for locally advanced nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: From September 2000 to June 2004, 50 patients with T3-T4 NPC were treated with intensity-modulated radiotherapy (IMRT).
  • Fourteen patients had Stage III and 36 patients had Stage IVA-IVB disease.
  • The prescribed dose was 76 Gy to gross tumor volume (GTV), 70 Gy to planning target volume (PTV), and 72 Gy to enlarged neck nodes (GTVn).
  • RESULTS: The average mean dose achieved in GTV, GTVn, and PTV were 79.5 Gy, 75.3 Gy, and 74.6 Gy, respectively.
  • All patients with recurrence had IMRT alone without chemotherapy.
  • One treatment-related death caused by adjuvant chemotherapy occurred.
  • CONCLUSIONS: Dose escalation to 76 Gy in tumor is feasible with T3-T4 NPC and can be combined with chemotherapy.
  • [MeSH-major] Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated / methods
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Radiation Injuries / complications. Stomatitis / etiology. Survival Analysis

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  • (PMID = 16213105.001).
  • [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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5. Chen HH, Tsai ST, Wang MS, Wu YH, Hsueh WT, Yang MW, Yeh IC, Lin JC: Experience in fractionated stereotactic body radiation therapy boost for newly diagnosed nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2006 Dec 1;66(5):1408-14
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  • [Title] Experience in fractionated stereotactic body radiation therapy boost for newly diagnosed nasopharyngeal carcinoma.
  • PURPOSE: Radiotherapy is the most effective treatment for nasopharyngeal carcinoma (NPC).
  • The aim of this study is to evaluate the efficacy and toxicity of fractionated stereotactic body radiation therapy (SBRT) boost for NPC.
  • METHODS AND MATERIALS: Sixty-four patients with newly diagnosed, nonmetastatic NPC were treated with conventional radiotherapy 64.8-68.4 Gy followed by fractionated SBRT boost 12-15 Gy between January 2002 and July 2004.
  • Most patients (72%) presented with Stage III-IV disease.
  • Fifty-two patients also received cisplatin-based concurrent (38) or neoadjuvant (14) chemotherapy.
  • After a median follow-up of 31 months (range, 22-54), 15 patients developed tumor recurrences--3 in the nasopharynx, 4 in the neck, 5 in distant sites, 1 in both nasopharynx and neck, 2 in the neck and a distant site.
  • The 3-year actuarial rate of local control was 93.1%, regional control 91.4%, freedom from distant metastasis 90.3%, and overall survival 84.9%, respectively.
  • CONCLUSIONS: Fractionated SBRT boost for NPC is technically feasible and provides good local control without any severe complications.
  • [MeSH-major] Carcinoma / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy. Stereotaxic Techniques
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy / methods. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Radiotherapy Dosage

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2007 Aug 1;68(5):1584-5; author reply 1585 [17674997.001]
  • (PMID = 17126207.001).
  • [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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6. 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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7. 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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8. Lee AW, Lau KY, Hung WM, Ng WT, Lee MC, Choi CW, Chan CC, Tung R, Cheng PT, Yau TK: Potential improvement of tumor control probability by induction chemotherapy for advanced nasopharyngeal carcinoma. Radiother Oncol; 2008 May;87(2):204-10
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  • [Title] Potential improvement of tumor control probability by induction chemotherapy for advanced nasopharyngeal carcinoma.
  • PURPOSE: To assess the reduction of tumor bulk and improvement of tumor control probability (TCP) by using induction chemotherapy for advanced nasopharyngeal carcinoma (NPC).
  • MATERIALS AND METHODS: From February to December 2005, 20 patients with Stage III-IVB NPC were treated with induction-concurrent chemotherapy and intensity-modulated radiotherapy with accelerated fractionation.
  • RESULTS: Nineteen (95%) patients completed all 3 cycles of induction chemotherapy and 90% had 2 cycles of concurrent chemotherapy.
  • Induction chemotherapy achieved significant down-staging of T-category in 35% of patients (p=0.016) and reduction of gross tumor volume (GTV_P) from 55.6 to 22.9cc (mean 61.4%, p<0.001).
  • CONCLUSIONS: Induction chemotherapy using cisplatin-5-fluorouracil could significantly reduce tumor bulk leading to potential improvement in tumor control.
  • [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. Combined Modality Therapy. Dose Fractionation. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy, Conformal. Remission Induction. Statistics, Nonparametric. Treatment Outcome

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  • (PMID = 18329742.001).
  • [ISSN] 0167-8140
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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9. Krstevska V, Stojkovski I, Klisarovska V: Concurrent chemoradiotherapy in locally and/or regionally advanced nasopharyngeal carcinoma. Prilozi; 2008 Dec;29(2):295-307
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  • [Title] Concurrent chemoradiotherapy in locally and/or regionally advanced nasopharyngeal carcinoma.
  • The aim of the study was to investigate the efficacy of concurrent chemoradiotherapy (CCRT) in patients with locally and/or regionally advanced nasopharyngeal carcinoma (NPC).
  • Between February 2005 and November 2007, 27 patients with advanced NPC were included in a prospective study of CCRT at the Radiotherapy and Oncology Institute in Skopje.
  • A dose of 69.4-71.4 Gy (median, 69.4 Gy) was delivered to the primary tumour and to the positive neck nodes.
  • Chemotherapy consisted of cisplatin 30 mg/m(2) given concomitantly with radiation on a weekly basis.
  • The median age was 49 years and 51.2% had stage IV disease.
  • Only one patient had a locoregional relapse and four patients developed distant metastases.
  • Considering the preliminary results of our study which do not indicate that the therapeutic effects of CCRT evaluated are comparable with the results from the randomised phase III studies, we recommend an effort for the routine use of the new radiotherapy technique, intensity-modulated radiation therapy (IMRT), as well as an initiation of a phase III trial addressing the definition of the precise role of sequential chemotherapy in the management of patients with locally advanced NPC.

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  • (PMID = 19259054.001).
  • [ISSN] 0351-3254
  • [Journal-full-title] Prilozi
  • [ISO-abbreviation] Prilozi
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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10. Cooper JS, Lee H, Torrey M, Hochster H: Improved outcome secondary to concurrent chemoradiotherapy for advanced carcinoma of the nasopharynx: preliminary corroboration of the intergroup experience. Int J Radiat Oncol Biol Phys; 2000 Jul 1;47(4):861-6
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  • [Title] Improved outcome secondary to concurrent chemoradiotherapy for advanced carcinoma of the nasopharynx: preliminary corroboration of the intergroup experience.
  • PURPOSE: The recent Intergroup 0099 trial of concurrent chemoradiotherapy for advanced nasopharyngeal carcinomas, demonstrated improved survival for chemoradiotherapy as compared to radiation therapy alone.
  • METHODS AND MATERIALS: Between 1995 and 1997, 35 consecutive patients, who had clinically nondisseminated Stage III or IV nasopharyngeal cancer, were treated by chemoradiotherapy.
  • Chemotherapy was designed to deliver cisplatin (100 mg/m(2) i.v.) on Days 1, 22, and 43 of radiation therapy and cisplatin (80 mg/m(2) i.v.) on Days 71, 99, and 127 plus flurouracil (5-FU; 1 g/m(2)/day by 96-h infusion) on Days 71-74, 99-102, and 127-130.
  • RESULTS: All patients had at least a partial response (PR) to treatment, including an 85% complete response (CR) rate.
  • Both represent substantial improvements over our institutional historical controls treated by radiation therapy alone and both are similar to the rates observed in the Intergroup trial.
  • CONCLUSION: Our data support the conclusion that concurrent chemoradiotherapy followed by adjuvant chemotherapy (as was used in Intergroup 0099) should be considered the current standard of care for patients who have advanced cancers of the nasopharynx.
  • [MeSH-major] Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Treatment Outcome

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  • (PMID = 10863053.001).
  • [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] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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11. 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.
  • 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).
  • 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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12. Fuwa N, Ito Y, Kodaira T, Matsumoto A, Kamata M, Furutani K, Tatibana H, Sasaoka M, Morita K: Therapeutic results of alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil: its usefulness and controversial points. Jpn J Clin Oncol; 2001 Dec;31(12):589-95
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  • [Title] Therapeutic results of alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil: its usefulness and controversial points.
  • BACKGROUND: The present study was conducted to evaluate the therapeutic results of alternating chemoradiotherapy for locally advanced nasopharyngeal cancer (NPC).
  • METHODS: The subjects consisted of six patients with stage III nasopharyngeal cancer and 26 patients with stage IV nasopharyngeal cancer.
  • Using 6 MV photons, radiotherapy was performed at an exposure of 1.8-2.0 Gy five times per week.
  • That is, a total absorbed dose of 36-40 Gy was irradiated between the base of the skull and supraclavicular fossa.
  • After decreasing the irradiation field, an absorbed dose of 26-30 Gy was additionally given thereafter.
  • One course of chemotherapy consisted of the administration of 5-fluorouracil (5-FU) at a dose of 700 mg/m2/24 h for 5 days (days 1-5) and cisplatin (CDDP) at a dose of 50 mg/m2/24 h for 2 days (days 6-7) and a total of 2-3 courses of chemotherapy were performed.
  • During the alternating chemoradiotherapy, chemotherapy was performed initially and 3-5 days after completing the chemotherapy, radiotherapy was performed for 3-4 weeks.
  • Thereafter, chemotherapy and radiotherapy were performed alternately.
  • Although one patient developed shock induced by metal allergy to CDDP, no severe adverse effects were noted in any other patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Radiotherapy Dosage. Survival Rate

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  • (PMID = 11902489.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; CF regimen
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13. 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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14. Lin JC, Jan JS, Hsu CY, Liang WM, Jiang RS, Wang WY: Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol; 2003 Feb 15;21(4):631-7
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  • [Title] Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival.
  • PURPOSE: Nasopharyngeal carcinoma (NPC) is a radiosensitive and chemosensitive tumor.
  • This randomized phase III trial compared concurrent chemoradiotherapy (CCRT) versus radiotherapy (RT) alone in patients with advanced NPC.
  • PATIENTS AND METHODS: From December 1993 to April 1999, 284 patients with 1992 American Joint Committee on Cancer stage III to IV (M0) NPC were randomly allocated into two arms.
  • The investigational arm received two cycles of concurrent chemotherapy with cisplatin 20 mg/m(2)/d plus fluorouracil 400 mg/m(2)/d by 96-hour continuous infusion during the weeks 1 and 5 of RT.
  • After a median follow-up of 65 months, 26.2% (37 of 141) and 46.2% (66 of 143) of patients developed tumor relapse in the CCRT and RT-alone groups, respectively.
  • Although significantly more toxicity was noted in the CCRT arm, including leukopenia and emesis, compliance with the combined treatment was good.
  • The second cycle of concurrent chemotherapy was refused by nine patients and was delayed for > or = 1 week for another nine patients.
  • There were no treatment-related deaths in either arm.
  • CONCLUSION: We conclude that CCRT is superior to RT alone for patients with advanced NPC in endemic areas.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Cisplatin / adverse effects. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Leukopenia / chemically induced. Male. Middle Aged. Survival Rate. Treatment Failure

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  • [CommentIn] J Clin Oncol. 2004 Jan 15;22(2):377; author reply 377-8 [14722048.001]
  • (PMID = 12586799.001).
  • [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 III; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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15. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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.
  • The 3-year progression-free survival for neoadjuvant versus control arm was 88.2% and 59.5% (hazard ratio = 0.49; 95% CI, 0.20 to 1.19; P = .12).
  • The 3-year overall survival for neoadjuvant versus control arm was 94.1% and 67.7% (hazard ratio = 0.24; 95% CI, 0.078 to 0.73; P = .012).
  • A phase III study to definitively test this neoadjuvant-concurrent strategy is warranted.
  • [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


16. Dong XR, Zhang T, Fan L, Zhang S, Wu G: Parotid gland metastasis of nasopharyngeal carcinoma: case report and review of the literature. J Int Med Res; 2009 Nov-Dec;37(6):1994-9
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  • [Title] Parotid gland metastasis of nasopharyngeal carcinoma: case report and review of the literature.
  • Parotid metastasis of nasopharyngeal carcinoma (NPC) is extremely rare.
  • The current case report presents the history of a 41-year old male with the primary symptom of a right parotid gland mass who was diagnosed with NPC by histopathology in 2006 and was staged as having cT(3)N(2)M(0) disease (stage III, American Joint Committee on Cancer staging system, 2002).
  • Histopathological examination of a partial excision of the mass on the right parotid and the neoplasm in the pharynx nasalis revealed poorly differentiated squamous cell carcinoma.
  • The patient received radiotherapy and concurrent chemotherapy.
  • Grade 2 skin reaction, grade 2 oropharyngeal mucositis and grade 3 xerostomia were detected during treatment.
  • The patient achieved a complete clinical response by 1 month after treatment.
  • The primary symptom of parotid gland mass in patients with NPC is commonly misdiagnosed and a pathological analysis can be considered a reliable method for confirming diagnosis.
  • [MeSH-major] Nasopharyngeal Neoplasms / pathology. Parotid Neoplasms / secondary
  • [MeSH-minor] Adult. Dose-Response Relationship, Radiation. Humans. Male. Tomography, X-Ray Computed

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  • (PMID = 20146900.001).
  • [ISSN] 0300-0605
  • [Journal-full-title] The Journal of international medical research
  • [ISO-abbreviation] J. Int. Med. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 20
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17. Lin JC, Wang WY, Chen KY, Wei YH, Liang WM, Jan JS, Jiang RS: Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma. N Engl J Med; 2004 Jun 10;350(24):2461-70
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  • [Title] Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma.
  • BACKGROUND: We investigated the clinical significance of plasma concentrations of Epstein-Barr virus (EBV) DNA in patients with advanced nasopharyngeal carcinoma.
  • METHODS: Ninety-nine patients with biopsy-proven stage III or IV nasopharyngeal carcinoma and no evidence of metastasis (M0) received 10 weekly chemotherapy treatments followed by radiotherapy.
  • Plasma samples from the patients were subjected to a real-time quantitative polymerase-chain-reaction assay.
  • RESULTS: Plasma EBV DNA was detectable before treatment in 94 of the 99 patients, but not in 40 healthy controls or 20 cured patients.
  • The median concentrations of plasma EBV DNA were 681 copies per milliliter among 25 patients with stage III disease, 1703 copies per milliliter among 74 patients with stage IV disease, and 291,940 copies per milliliter among 19 control patients with distant metastasis (P<0.001).
  • Patients with relapse had a significantly higher plasma EBV DNA concentration before treatment than those who did not have a relapse (median, 3035 vs. 1202 copies per milliliter; P=0.02).
  • The consistent genotyping of EBV DNA between paired samples of plasma and primary tumor suggested that the circulating cell-free EBV DNA may originate from the primary tumor.
  • CONCLUSIONS: Quantification of plasma EBV DNA is useful for monitoring patients with nasopharyngeal carcinoma and predicting the outcome of treatment.
  • [MeSH-major] DNA, Viral / blood. Herpesvirus 4, Human / genetics. Nasopharyngeal Neoplasms / virology
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Case-Control Studies. Combined Modality Therapy. Female. Genotype. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Polymerase Chain Reaction. Prognosis. Proportional Hazards Models. Prospective Studies. Recurrence. Survival Analysis. Treatment Outcome. Viral Load

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  • [Copyright] Copyright 2004 Massachusetts Medical Society
  • (PMID = 15190138.001).
  • [ISSN] 1533-4406
  • [Journal-full-title] The New England journal of medicine
  • [ISO-abbreviation] N. Engl. J. Med.
  • [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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18. Chan AT, Teo PM, Ngan RK, Leung TW, Lau WH, Zee B, Leung SF, Cheung FY, Yeo W, Yiu HH, Yu KH, Chiu KW, Chan DT, Mok T, Yuen KT, Mo F, Lai M, Kwan WH, Choi P, Johnson PJ: Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial. J Clin Oncol; 2002 Apr 15;20(8):2038-44
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  • [Title] Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial.
  • PURPOSE: Nasopharyngeal carcinoma (NPC) is highly sensitive to both radiotherapy (RT) and chemotherapy.
  • This randomized phase III trial compared concurrent cisplatin-RT (CRT) with RT alone in patients with locoregionally advanced NPC.
  • PATIENTS AND METHODS: Patients with Ho's N2 or N3 stage or N1 stage with nodal size > or = 4 cm were randomized to receive cisplatin 40 mg/m(2) weekly up to 8 weeks concurrently with radical RT (CRT) or RT alone.
  • There were no treatment-related deaths in the CRT arm, and one patient died during treatment in the RT-alone arm.
  • The treatment effect had a significant covariate interaction with tumor stage, and a subgroup analysis demonstrated a highly significant difference in favor of the CRT arm in Ho's stage T3 (P =.0075) with a hazards ratio of 2.328 (95% CI, 1.26 to 4.28).
  • For T3 stage, the time to first distant failure was statistically significantly different in favor of the CRT arm (P =.016).
  • CONCLUSION: Concurrent CRT is well tolerated in patients with advanced NPC in endemic areas.
  • Although PFS was not significantly different between the concurrent CRT arm and the RT-alone arm in the overall comparison, PFS was significantly prolonged in patients with advanced tumor and node stages.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cisplatin / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Survival Analysis


19. 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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20. 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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21. Lu JJ, Shakespeare T, Goh BC, Tiong CE, Back M, Mukherjee R, Wynne CJ, Tan KS: Adjuvant high-dose rate brachytherapy after chemoradiation for treatment of early T-stage nasopharyngeal carcinoma. Am J Clin Oncol; 2004 Apr;27(2):132-5
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  • [Title] Adjuvant high-dose rate brachytherapy after chemoradiation for treatment of early T-stage nasopharyngeal carcinoma.
  • The local control of nasopharyngeal carcinoma after conventional radiotherapy has historically been suboptimal.
  • The purpose of this analysis of our prospective treatment protocol was to evaluate the additional value of high-dose rate intracavitary brachytherapy (HDRIB) on the disease response, local control, and survival.
  • Between March 1999 and January 2001, 16 patients with newly diagnosed locally advanced (stage III and IV) nasopharyngeal carcinoma were treated prospectively at the Radiation Oncology Department of the National University Hospital of Singapore.
  • All patients were staged according to the AJCC (1997) Staging System and had early T stages (T1 and T2).
  • Treatments included concurrent external beam radiotherapy (EBRT) and chemotherapy as follows: 66 Gy to the primary tumor in conventional fractionation with cisplatin based concurrent chemotherapy followed by adjuvant cisplatin and 5-fluorouracil (5-FU) chemotherapy.
  • Ten Gy of HDRIB in 2 weekly fractions were delivered after the completion of EBRT to all 16 patients.
  • All patients were evaluable for treatment response, local control, survival, and toxicity analysis.
  • All patients obtained pathologic complete response at the primary site at 4 months after the completion of the treatment.
  • At the time of this analysis, 15 (93.8%) patients are alive with no evidence of disease.
  • One patient (6.2%) developed locoregional recurrence in the neck at 9 months, and distant metastasis at 11 months after the completion of treatment.
  • A prospective study is being planned to further evaluate the role of adjuvant HDRIB after concurrent chemoradiation on treatment outcome.
  • [MeSH-major] Brachytherapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Radiotherapy Dosage. Survival Analysis. Treatment Outcome

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  • (PMID = 15057151.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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22. Lee CC, Huang TT, Lee MS, Hsiao SH, Lin HY, Su YC, Hsu FC, Hung SK: Clinical application of tumor volume in advanced nasopharyngeal carcinoma to predict outcome. Radiat Oncol; 2010;5:20
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  • [Title] Clinical application of tumor volume in advanced nasopharyngeal carcinoma to predict outcome.
  • BACKGROUND: Current staging systems have limited ability to adjust optimal therapy in advanced nasopharyngeal carcinoma (NPC).
  • This study aimed to delineate the correlation between tumor volume, treatment outcome and chemotherapy cycles in advanced NPC.
  • METHODS: A retrospective review of 110 patients with stage III-IV NPC was performed.
  • All patients were treated first with neoadjuvant chemotherapy, then concurrent chemoradiation, and followed by adjuvant chemotherapy as being the definitive therapy.
  • Gross tumor volume of primary tumor plus retropharyngeal nodes (GTVprn) was calculated to be an index of treatment outcome.
  • RESULTS: GTVprn had a close relationship with survival and recurrence in advanced NPC.
  • In patients with GTVprn > or =13 ml, overall survival was better after > or =4 cycles of chemotherapy than after less than 4 cycles.
  • CONCLUSIONS: The incorporation of GTVprn can provide more information to adjust treatment strategy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / pathology. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / pathology. Neoplasm Staging / methods
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Humans. Kaplan-Meier Estimate. Lymphatic Metastasis / pathology. Male. Middle Aged. Proportional Hazards Models. Radiotherapy, Intensity-Modulated. Retrospective Studies. Tomography, X-Ray Computed. Treatment Outcome. Tumor Burden / drug effects. Tumor Burden / radiation effects

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  • (PMID = 20222940.001).
  • [ISSN] 1748-717X
  • [Journal-full-title] Radiation oncology (London, England)
  • [ISO-abbreviation] Radiat Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2842277
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23. 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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24. Lu TX, Mai WY, Teh BS, Zhao C, Han F, Huang Y, Deng XW, Lu LX, Huang SM, Zeng ZF, Lin CG, Lu HH, Chiu JK, Carpenter LS, Grant WH 3rd, Woo SY, Cui NJ, Butler EB: Initial experience using intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2004 Mar 1;58(3):682-7
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  • [Title] Initial experience using intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma.
  • PURPOSE: To report our initial experience on the feasibility, toxicity, and tumor control using intensity-modulated radiotherapy (IMRT) for retreatment of recurrent nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: A total of 49 patients with locoregional recurrent carcinoma in the nasopharynx were treated with IMRT between January 2001 and February 2002 at the Sun Yat-Sen University Cancer Center, Guangzhou, China.
  • The average time to the nasopharyngeal recurrence was 30.2 months after initial conventional RT.
  • The median isocenter dose to the nasopharynx was 70 Gy (range 60.9-78.0) for the initial conventional RT.
  • All patients were restaged at the time of recurrence according to the 1992 Fuzhou, China staging system on NPC.
  • The number of patients with Stage I, II, III and IV disease was 4, 9, 10, and 26, respectively.
  • The GTV in the nasopharynx and positive lymph nodes in the neck received a prescription dose of 68-70 Gy and 60 Gy, respectively.
  • Three patients who had positive lymph nodes were treated with five to six courses of chemotherapy (cisplatin + 5-fluorouracil) after IMRT.
  • RESULTS: The treatment plans showed that the percentage of GTV receiving 95% of the prescribed dose (V(95-GTV)) was 98.5%, and the dose encompassing 95% of GTV (D(95-GTV)) was 68.1 Gy in the nasopharynx.
  • The mean dose to the GTV was 71.4 Gy.
  • Three patients developed metastases at a distant site: two in the bone and one in the liver and lung at 13 months follow-up.
  • Acute toxicity (skin, mucosa, and xerostomia) was acceptable according to the Radiation Therapy Oncology Group criteria.
  • CONCLUSION: The improvement in tumor target coverage and significant sparing of adjacent critical structures allow the feasibility of IMRT as a retreatment option for recurrent NPC after initial conventional RT.
  • This is the first large series using IMRT to reirradiate local recurrent NPC after initial RT failed.
  • The treatment-related toxicity profile was acceptable.
  • In contrast to primary NPC, recurrent NPC reirradiated with high-dose IMRT led to the shedding of tumor necrotic tissue toward the end of RT.
  • More patients and longer term follow-up are warranted to evaluate late toxicity and treatment outcome.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Neoplasm Recurrence, Local / radiotherapy. Radiotherapy, Conformal / methods

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  • (PMID = 14967420.001).
  • [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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25. Jiang G, Min H, Zhang J, Huang Y: [Value of regional intra-arterial induction chemotherapy for locally advanced nasopharyngeal carcinoma]. Zhonghua Er Bi Yan Hou Ke Za Zhi; 2001 Oct;36(5):376-9
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  • [Title] [Value of regional intra-arterial induction chemotherapy for locally advanced nasopharyngeal carcinoma].
  • OBJECTIVE: To define the value of regional intra-arterial induction chemotherapy for locally advanced nasopharyngeal carcinoma (NPC).
  • METHODS: 121 locally advanced NPC(stage III-IV) patients confirmed by pathology were randomly divided into two groups before radiation, and the two groups were given two different methods of chemotherapy: regional intra-arterial chemotherapy (IACT) and systemic chemotherapy (SCT).
  • CONCLUSION: IACT is more reasonable than SCT as induction chemotherapy for these locally advanced NPC.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Carcinoma, Squamous Cell / drug therapy. Nasopharyngeal Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Combined Modality Therapy. Female. Humans. Infusions, Intra-Arterial. Male. Middle Aged. Survival Rate

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  • (PMID = 12761949.001).
  • [ISSN] 0412-3948
  • [Journal-full-title] Zhonghua er bi yan hou ke za zhi
  • [ISO-abbreviation] Zhonghua Er Bi Yan Hou Ke Za Zhi
  • [Language] chi
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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26. Krstevska V, Stojkovski I: Chemotherapy in locoregionally advanced nasopharyngeal carcinoma-a review. J BUON; 2008 Oct-Dec;13(4):495-503
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  • [Title] Chemotherapy in locoregionally advanced nasopharyngeal carcinoma-a review.
  • Locoregionally advanced nasopharyngeal carcinoma (NPC), when traditionally treated with radiotherapy (RT) alone, has been associated with low overall survival (OS).
  • Efforts to improve the efficacy of treatment for locoregionally advanced NPC have led to the use of multimodality approach with combination of RT and chemotherapy (CT).
  • Analyzing the historical progress of the incorporation of CT as an integral part of the management of advanced NPC, we reviewed 12 randomized controlled trials on induction, concurrent, and adjuvant therapy, or a combination of these approaches.
  • Evidence that concurrent chemoradiotherapy (CCRT) provides significant improvement in OS in patients with locoregionally advanced NPC is based on the results of 2 meta-analyses and several randomized studies on the administration of CT concomitantly with RT.
  • The revealed survival benefits with CCRT compared with RT alone resulted in confirmation of CCRT as the currently recommended treatment for patients with advanced-stage NPC.
  • The recognition of the development of distant metastatic disease as more frequent pattern of failure when concurrent CT is utilized has led to the assumption that the use of both induction chemotherapy (ICT) and CCRT in a sequential manner may provide improvement in overall treatment outcome in this patient category.
  • The definition of the precise role of sequential CT in the management of patients with locally advanced NPC is to be revealed from the results of future phase III trials addressing this issue.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Randomized Controlled Trials as Topic

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  • (PMID = 19145670.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Greece
  • [Number-of-references] 46
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27. Chua DT, Ma J, Sham JS, Mai HQ, Choy DT, Hong MH, Lu TX, Au GK, Min HQ: Improvement of survival after addition of induction chemotherapy to radiotherapy in patients with early-stage nasopharyngeal carcinoma: Subgroup analysis of two Phase III trials. Int J Radiat Oncol Biol Phys; 2006 Aug 1;65(5):1300-6
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  • [Title] Improvement of survival after addition of induction chemotherapy to radiotherapy in patients with early-stage nasopharyngeal carcinoma: Subgroup analysis of two Phase III trials.
  • PURPOSE: Induction chemotherapy has not been shown to improve survival in nasopharyngeal carcinoma (NPC) in Phase III trials.
  • To evaluate the effect of induction chemotherapy in NPC further, we performed subgroup analysis of two Phase III trials according to the T and N stage.
  • METHODS AND MATERIALS: Data from two phase III trials comparing cisplatin/epirubicin or cisplatin/bleomycin/5-fluorouracil followed by radiotherapy (RT) vs. RT alone in NPC were pooled together for analysis.
  • Patients were stratified into four subgroups according to the 1997 American Joint Committee on Cancer T and N stage: T1-T2N0-N1, Group 1 (early-stage disease); T1-T2N2-N3, Group 2 (advanced N disease); T3-T4N0-N1, Group 3 (advanced T stage); and T3-T4N2-N3, Group 4 (advanced T and N disease).
  • Group 1 consisted entirely of patients with Stage IIB disease.
  • Significant differences in the overall survival and distant metastasis-free rates were observed only in Group 1, favoring the combined chemotherapy and RT arm.
  • CONCLUSIONS: Our results have shown that patients in Group 1, with early-stage NPC treated by RT alone, had relatively poor survival because of distant metastases.
  • The observation of improved outcomes in this subgroup after the addition of induction chemotherapy has not been previously reported and warrants additional investigation.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Epirubicin / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Staging. Remission Induction. Survival Rate

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  • (PMID = 16750333.001).
  • [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; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin
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28. 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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  • [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.
  • The 3-year RFS rates in the ST, RT, and CT group were 39%, 7%, and 0%, respectively.
  • For regional disease, the 3-year nodal control rate after radical neck dissection was 65% compared with 24% by reirradiation.
  • 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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29. Ku PK, Yuen EH, Cheung DM, Chan BY, Ahuja A, Leung SF, Tong MC, van Hasselt A: Early swallowing problems in a cohort of patients with nasopharyngeal carcinoma: Symptomatology and videofluoroscopic findings. Laryngoscope; 2007 Jan;117(1):142-6
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  • [Title] Early swallowing problems in a cohort of patients with nasopharyngeal carcinoma: Symptomatology and videofluoroscopic findings.
  • OBJECTIVE: To study the incidence and the degree of swallowing dysfunction in patients with nasopharyngeal carcinoma (NPC) who underwent radiation therapy treatment.
  • MATERIALS AND METHODS: From October 1999 to July 2001, a cohort of 20 consecutive patients with newly diagnosed NPC was prospectively studied.
  • Questions about symptoms, including swallowing functions, were asked, and head and neck examination including oromotor examination was performed in the subjects before radiation therapy.
  • Nine patients had early (stage I and II) disease, whereas 11 patients had advanced (stage III and IV) disease.
  • Nine patients were treated by radiation therapy only and 11 patients by concurrent chemoirradiation.
  • Ninety-five percent of the subjects had subjective dysphagia at 6 and 12 months after radiation therapy.
  • Ninety percent had xerostomia, and 80% had to avoid certain foods at 12 months postradiation therapy.
  • CONCLUSIONS: Subjective swallowing difficulties were common in patients in the early follow-up period after radiation therapy for NPC according to questionnaire assessment.
  • An objective swallowing study revealed that swallowing dysfunction was persistent 12 months after radiation therapy.
  • [MeSH-major] Carcinoma / complications. Deglutition Disorders / etiology. Nasopharyngeal Neoplasms / complications. Surveys and Questionnaires
  • [MeSH-minor] Adult. Combined Modality Therapy. Deglutition / drug effects. Deglutition / radiation effects. Feeding Behavior. Female. Fluoroscopy / methods. Humans. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Video Recording


30. 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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31. Franchin G, Vaccher E, Talamini R, Gobitti C, Minatel E, Politi D, Sartor G, Trovò MG, Barzan L: Nasopharyngeal cancer WHO type II-III: monoinstitutional retrospective analysis with standard and accelerated hyperfractionated radiation therapy. Oral Oncol; 2002 Feb;38(2):137-44
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  • [Title] Nasopharyngeal cancer WHO type II-III: monoinstitutional retrospective analysis with standard and accelerated hyperfractionated radiation therapy.
  • The aim of this study is to assess the impact of prognostic factors in patients with locoregionally advanced nasopharyngeal cancer (NPC), WHO type II-III, treated with two different radiation therapy (RT) schedules: standard radiation therapy (SRT), and accelerated hyperfractionated radiation therapy (HART), with or without sequential chemotherapy.
  • Between January 1986 and December 1999, 78 consecutive NPC patients were treated either with SRT (until August 1993) or with HART (from September 1993).
  • Nine patients had a non-keratinizing carcinoma (WHO type II) and 69 an undifferentiated carcinoma (WHO type III).
  • A multivariate analysis, age (hazard ratio, HR=4.17 for > or = 60 vs. <50 years) and N-stage (HR=3.56 for N3a-N3b vs. N0-N1) were significant for survival, whereas N-stage (HR=8.23 for N3a-N3b vs. N0-N1) and RT schedule (HR=0.30 for HART vs. SRT) were significant for DFS.
  • [MeSH-major] Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Age Factors. Aged. Aged, 80 and over. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Disease-Free Survival. Dose Fractionation. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 11854060.001).
  • [ISSN] 1368-8375
  • [Journal-full-title] Oral oncology
  • [ISO-abbreviation] Oral Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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32. 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.
  • 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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33. 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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34. 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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35. 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.
  • The 3-year actuarial rate of local regional control was 86%; distant metastases-free survival, progression-free survival and overall survival at 3 years were 81%, 69% and 76%, respectively.
  • 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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36. 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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37. Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, Chua ET, Yang E, Lee KM, Fong KW, Tan HS, Lee KS, Loong S, Sethi V, Chua EJ, Machin D: Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol; 2005 Sep 20;23(27):6730-8
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  • [Title] Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety.
  • PURPOSE: The Intergroup 00-99 Trial for nasopharyngeal cancer (NPC) showed a benefit of adding chemotherapy to radiotherapy.
  • This study aims to confirm the findings of the 00-99 Trial and its applicability to patients with endemic NPC.
  • Patients in both arms received 70 Gy in 7 weeks using standard RT portals and techniques.
  • The median follow-up time was 3.2 years.
  • CONCLUSION: This report confirms the findings of the Intergroup 00-99 Trial and demonstrates its applicability to endemic NPC.
  • This study also confirms that chemotherapy improves the distant metastasis control rate in NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Endemic Diseases. Nasopharyngeal Neoplasms / epidemiology. Nasopharyngeal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Probability. Proportional Hazards Models. Radiotherapy Dosage. Radiotherapy, Adjuvant. Reference Values. Risk Assessment. Singapore / epidemiology. Survival Analysis. Treatment Outcome

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  • (PMID = 16170180.001).
  • [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; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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38. Fischer M, Pöttgen C, Wechsler S, Stuschke M, Jahnke K: [Accelerated hyperfractionated radiotherapy with concurrent chemotherapy in locally advanced nasopharyngeal carcinomas]. HNO; 2007 Dec;55(12):950-5
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  • [Title] [Accelerated hyperfractionated radiotherapy with concurrent chemotherapy in locally advanced nasopharyngeal carcinomas].
  • [Transliterated title] Lokal fortgeschrittene Nasopharynxkarzinome. Hyperfraktioniert-akzelerierte Radiotherapie mit simultaner Chemotherapie.
  • BACKGROUND: The excellent results yielded by hyperfractionated and accelerated radiotherapy associated with concurrent chemotherapy in locally advanced oropharyngeal and hypopharyngeal carcinomas led to investigation of this therapeutic regimen in nasopharyngeal carcinomas also.
  • METHODS: Thirty-five patients with stage III and IV nasopharyngeal carcinomas received accelerated hyperfractionated radiotherapy with concurrent chemotherapy (5-FU, mitomycin C + leucovorin).
  • In the first 3 weeks of treatment five 2-Gy doses per week were delivered to the primary tumour and regional lymph nodes.
  • The fractionation was then accelerated, with 1.4 Gy given twice daily until a total dose of 72 Gy had been administered.
  • Salvage surgery of the lymph nodes was performed in 10 patients, revealing vital tumour tissue in 6 of these.
  • CONCLUSION: Hyperfractionated accelerated radiotherapy with concurrent chemotherapy is effective and feasible in locally advanced nasopharyngeal carcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Neoplasm Recurrence, Local / prevention & control. Radiotherapy, Conformal / methods
  • [MeSH-minor] Adult. Aged. Dose Fractionation. Feasibility Studies. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 17356874.001).
  • [ISSN] 1433-0458
  • [Journal-full-title] HNO
  • [ISO-abbreviation] HNO
  • [Language] ger
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] Germany
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39. 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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40. 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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41. Olajos J, Füle E, Erfán J, Krenács L, Stelkovics E, Francz M, Lengyel E, Al-Farhat Y, Esik O: Familial clustering of nasopharyngeal carcinoma in a non-endemic geographical region. Report of two Hungarian cases and a review of the literature. Acta Otolaryngol; 2005 Sep;125(9):1008-13
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  • [Title] Familial clustering of nasopharyngeal carcinoma in a non-endemic geographical region. Report of two Hungarian cases and a review of the literature.
  • The aim of this study was to investigate the familial clustering of nasopharyngeal carcinoma (NPC) in a non-endemic geographical region on the basis of two case reports and a review of the literature.
  • Following an upper respiratory infection, NPC (WHO type III) was detected in a 57-year-old female (Case 1) who presented with nasal symptoms and a year later in her 36-year-old son (Case 2) who presented with enlarged lymph nodes.
  • After a full diagnostic work-up, cT2a cN0 cM0 (stage IIA; Case 1) and cT2a cN2 cM0 (stage III; Case 2) disease were identified, and telecobalt irradiation was administered to both patients.
  • After initial complete remission, the son experienced regional (cervical) and base of the skull relapses within 2 years, which were treated unsuccessfully by means of radical neck dissection, a second course of radiotherapy and chemotherapy.
  • The authors review 20 additional well-documented cases of familial clustering of NPC in non-endemic geographical regions from the English language literature.
  • This clinical entity typically has WHO type III histology; it may occur following an upper respiratory tract infection, and EBV-related serological titers were elevated in all 20 investigated cases.
  • The present two cases and the review of the literature strongly suggest that familial clustering of NPC in non-endemic geographical areas may be related to EBV infections.
  • The difference in outcome of our two cases may be explained by the fact that the disease in Case 2 was diagnosed 1 year later than that in Case 1 and hence at a more advanced stage.
  • [MeSH-major] Nasopharyngeal Neoplasms / genetics

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  • (PMID = 16193593.001).
  • [ISSN] 0001-6489
  • [Journal-full-title] Acta oto-laryngologica
  • [ISO-abbreviation] Acta Otolaryngol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Norway
  • [Number-of-references] 25
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42. Chua DT, Nicholls JM, Sham JS, Au GK: Prognostic value of epidermal growth factor receptor expression in patients with advanced stage nasopharyngeal carcinoma treated with induction chemotherapy and radiotherapy. Int J Radiat Oncol Biol Phys; 2004 May 1;59(1):11-20
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  • [Title] Prognostic value of epidermal growth factor receptor expression in patients with advanced stage nasopharyngeal carcinoma treated with induction chemotherapy and radiotherapy.
  • PURPOSE: A retrospective study was performed to correlate the expression of epidermal growth factor receptor (EGFR) with treatment outcome in advanced stage nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: The study population comprised 54 of 92 patients with American Joint Committee on Cancer Stage III-IV NPC with sufficient pretreatment tumor biopsy specimens for study.
  • All patients were treated by induction chemotherapy with two to three cycles of cisplatin 60 mg/m(2) and epirubicin 110 mg/m(2) every 3 weeks followed by radiotherapy.
  • The median follow-up time was 52 months for all patients and 99 months for surviving patients.
  • No correlation was found between EGFR expression and T stage, N stage, stage group, nodal size, gender, and age.
  • No statistically significant differences in chemotherapy response rates were found in patients with different EGFR intensity and extent.
  • EGFR extent > or =25% was associated with a significantly poorer treatment outcome.
  • In multivariate analysis, EGFR extent was the only independent factor that predicted for disease relapse, locoregional failure, and cancer death.
  • CONCLUSION: Our study results showed that EGFR expression was common in advanced stage NPC, and the expression did not correlate with tumor or nodal stage.
  • Correlative analysis showed that EGFR extent was a strong, independent prognostic factor that determined locoregional control, relapse-free survival, and disease-specific survival in Stage III-IV NPC treated with induction chemotherapy and radiotherapy.
  • Our findings suggest that EGFR expression status can identify a subgroup of patients within advanced stage disease that will have a poor outcome after induction chemotherapy and radiotherapy.
  • Whether this patient subgroup will benefit from an alternate treatment strategy and anti-EGFR-targeted treatment requires additional studies.
  • [MeSH-major] Nasopharyngeal Neoplasms / metabolism. Neoplasm Proteins / metabolism. Receptor, Epidermal Growth Factor / metabolism
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Epirubicin / administration & dosage. Female. Humans. Male. Neoplasm Staging. Proportional Hazards Models. Radiotherapy Dosage. Retrospective Studies. Treatment Outcome

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  • (PMID = 15093894.001).
  • [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 / Neoplasm Proteins; 3Z8479ZZ5X / Epirubicin; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; Q20Q21Q62J / Cisplatin
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43. Leung TW, Tung SY, Sze WK, Sze WM, Wong VY, O SK: Salvage brachytherapy for patients with locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2000 May 1;47(2):405-12
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  • [Title] Salvage brachytherapy for patients with locally persistent nasopharyngeal carcinoma.
  • PURPOSE: Locally persistent nasopharyngeal carcinoma (NPC) carries an increased risk of local failure if additional treatment is not given.
  • This study was conducted to evaluate the outcomes of patients with locally persistent NPC as treated by high-dose-rate (HDR) intracavitary brachytherapy, and to explore whether routine brachytherapy boost could improve the local control.
  • METHODS AND MATERIALS: Eighty-seven patients with locally persistent NPC treated during 1990-1998 with HDR intracavitary brachytherapy were retrospectively analyzed.
  • Fibreoptic nasopharyngoscopy was performed 3-6 weeks after completion of the primary external radiation therapy (ERT).
  • Eighty-seven patients were shown to have persistent viable disease at a median time of 6 weeks post-RT.
  • The distribution according to Ho's staging system at initial diagnosis was as follows: Stage I-8, II-33, III-41, IV-5; T1-19, T2-48, T3-20; N0-32, N1-22, N2-28, N3-5.
  • They were treated with HDR intracavitary brachytherapy, with either cobalt sources or an iridium source, giving 22.5-24 Gy in 3 weekly sessions in all but 4 patients.
  • Twelve patients were treated with neoadjuvant chemotherapy.
  • In assessing the local control, only the T staging was significant on multivariate analysis (p = 0.0004).
  • In the persistent group, the local failure rates of the patients treated with and without neoadjuvant chemotherapy were 17% (2/12) and 13% (10/75) respectively.
  • When early T-stage (T1 and T2) patients were grouped together for analysis, the iridium group again showed a statistically significant improvement in 5-year LFFS rate when it was compared with the cobalt group (95.3% vs. 76.5%, p = 0.03) and the ERT alone group (95.3% vs. 81.5%, p = 0.03).
  • The improvement of local control is attributed to a higher nasopharyngeal mucosal dose that is achieved by using small-size flexible applicators with an iridium source.
  • This information supports our speculation that an adequate booster treatment could compensate for inadequate primary treatment.
  • The prognosis of patients with locally recurrent NPC is grave.
  • [MeSH-major] Brachytherapy / methods. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Analysis of Variance. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Chemotherapy, Adjuvant. Cobalt / therapeutic use. Disease-Free Survival. Female. Humans. Iridium / therapeutic use. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Radiopharmaceuticals / therapeutic use. Retrospective Studies. Salvage Therapy

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  • (PMID = 10802367.001).
  • [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] 0 / Radiopharmaceuticals; 3G0H8C9362 / Cobalt; 44448S9773 / Iridium
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44. 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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45. 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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46. Tham IW, Hee SW, Yeo RM, Salleh PB, Lee J, Tan TW, Fong KW, Chua ET, Wee JT: Treatment of nasopharyngeal carcinoma using intensity-modulated radiotherapy-the national cancer centre singapore experience. Int J Radiat Oncol Biol Phys; 2009 Dec 1;75(5):1481-6
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  • [Title] Treatment of nasopharyngeal carcinoma using intensity-modulated radiotherapy-the national cancer centre singapore experience.
  • PURPOSE: The aim of this study was to determine the efficacy and acute toxicity of our early experience with treating nasopharyngeal carcinoma (NPC) patients with intensity-modulated radiotherapy (IMRT).
  • METHODS AND MATERIALS: A review was conducted on case records of 195 patients with histologically proven, nonmetastatic NPC treated with IMRT between 2002 and 2005.
  • All plans had target volumes at three dose levels, with a prescribed dose of 70 Gy to the gross disease, in 2.0-2.12 Gy/fraction over 33-35 fractions.
  • Cisplatin-based chemotherapy was offered to Stage III/IV patients.
  • One hundred and twenty-three patients had Stage III/IV disease (63%); 50 (26%) had T4 disease.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents / therapeutic use. Cancer Care Facilities. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Disease-Free Survival. Dose Fractionation. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Radiotherapy Planning, Computer-Assisted. Remission Induction. Retrospective Studies. Singapore. Tumor Burden. Young Adult

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  • (PMID = 19386431.001).
  • [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] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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47. 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.
  • The 3-year actuarial LRFS, NRFS, DMFS, and OS were 92%, 98%, 79%, and 90%, respectively.
  • 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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48. Levendag PC, Nijdam WM, van Agthoven M, Uyl-de Groot CA: Chemotherapy and high-dose-rate brachytherapy in the management of advanced cancers of the nasopharynx: clinical impact of high technology--is it worth the cost? Brachytherapy; 2002;1(1):11-20
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  • [Title] Chemotherapy and high-dose-rate brachytherapy in the management of advanced cancers of the nasopharynx: clinical impact of high technology--is it worth the cost?
  • PURPOSE: The aim of this study was to calculate the costs of chemotherapy and high-dose-rate brachytherapy in advanced-stage nasopharyngeal cancer.
  • It is argued whether the effect of chemotherapy and this type of high-dose, high-precision radiation therapy is worth the costs.
  • METHODS AND MATERIALS: Clinical results of Stage III-IVB nasopharyngeal cancer in patients treated between 1991 and 2000 are reported.
  • Treatment was broken down into five categories: workup, chemotherapy, preparation of radiation therapy, and application of radiation.
  • Nasopharyngeal cancer treatment costs were compared with costs previously reported on patients treated for cancers of the oral cavity, larynx, and oropharynx.
  • RESULTS: With the addition of neoadjuvant chemotherapy and high cumulative doses of radiation (77-81 Gy) with brachytherapy, disease-free survival increased from 48% to 74% (p=0.002), and overall survival increased from 35% to 72% (p=0.005).
  • The Rotterdam protocol has been implemented stepwise: as of 1991, costs per patient increased from 4521 Euros (US$5023; 2001 exchange rate [December]: 1 Euro approximately 0.88 US$) for conventional external beam radiation therapy to 13,728 Euros (US$15,253) in 2000 for combinations of chemotherapy, conventional external beam radiation therapy, and brachytherapy.
  • CONCLUSIONS: Costs for cancer in the nasopharynx vary from 14,528 Euros (US$16,509) to 15,316 Euros (US$17,405) in case of brachytherapy and stereotactic radiotherapy, respectively, if follow-up costs are added.
  • The treatment cost for other head and neck sites was 21,858 Euros (US$24,126).
  • Given the improvement in survival, the sparing capabilities of current high-dose, high-precision radiotherapy techniques, and the favorable cost profile compared with other sites, it is argued that costs should not be considered prohibitive for the introduction of chemotherapy and high-technology-based radiotherapy in advanced nasopharyngeal cancer.
  • [MeSH-major] Brachytherapy / economics. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Costs and Cost Analysis. Humans. Neoplasm Staging. Radiotherapy Dosage. Time Factors

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  • (PMID = 15062182.001).
  • [ISSN] 1538-4721
  • [Journal-full-title] Brachytherapy
  • [ISO-abbreviation] Brachytherapy
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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49. Levendag PC, Lagerwaard FJ, de Pan C, Noever I, van Nimwegen A, Wijers O, Nowak PJ: High-dose, high-precision treatment options for boosting cancer of the nasopharynx. Radiother Oncol; 2002 Apr;63(1):67-74
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  • [Title] High-dose, high-precision treatment options for boosting cancer of the nasopharynx.
  • PURPOSE: The aim of the study is to define the role and type of high-dose, high-precision radiation therapy for boosting early staged T1,2a, but in particular locally advanced, T2b-4, nasopharyngeal cancer (NPC).
  • MATERIALS AND METHODS: Ninety-one patients with primary stage I-IVB NPC, were treated between 1991 and 2000 with 60-70Gy external beam radiation therapy (ERT) followed by 11-18Gy endocavitary brachytherapy (ECBT) boost.
  • In 1996, for stage III-IVB disease, cisplatinum (CDDP)-based neoadjuvant chemotherapy (CHT) was introduced per protocol.
  • After matching with pre-treatment computed tomogram, patients (response) were graded into four categories; i.e.
  • LD (T1,2a, with limited disease, i.e. disease confined to nasopharynx), LRD (T2b, with limited residual disease), ERD (T2b, with extensive residual disease), or patients initially diagnosed with T3,4 tumors.
  • Dose distributions for ECBT (Plato-BPS v. 13.3, Nucletron) were compared to parallel-opposed three-dimensional conformal radiation therapy (Cadplan, Varian Dosetek v. 3.1), intensity modulated radiation therapy (IMRT) (Helios, Varian) and stereotactic radiotherapy (SRT) (X-plan, Radionics v. 2.02).
  • RESULTS: For stage T1,2N0,1 tumors, at 2 years local control of 96% and overall survival of 80% were observed.
  • CONCLUSIONS: The dosimetric findings, ease of application of the brachytherapy procedure, and the clinical results in early staged NPC, necessitates ERT combined with brachytherapy boost to be the therapy of preference for LD and LRD.
  • For locally advanced T3,4 tumors, our current protocol indicates neoadjuvant chemotherapy in conjunction with high cumulative doses of radiotherapy (81Gy); IMRT and/or SRT to be the preferred technique for boosting the primary tumor.
  • [MeSH-major] Brachytherapy / methods. Carcinoma / radiotherapy. Dose Fractionation. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Neoadjuvant Therapy. Neoplasm Staging. Radiotherapy, Conformal / methods. Retrospective Studies. Survival Rate

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  • (PMID = 12065105.001).
  • [ISSN] 0167-8140
  • [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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50. 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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51. 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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52. Al-Sarraf M, Reddy MS: Nasopharyngeal carcinoma. Curr Treat Options Oncol; 2002 Feb;3(1):21-32
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  • [Title] Nasopharyngeal carcinoma.
  • Nasopharyngeal carcinoma is usually present as locally advanced (stage III or IV) disease.
  • Before 1980, the primary treatment was radiotherapy.
  • The 5-year survival rate of patients with stage IVM0 across the world was less than 30%.
  • Sequential chemotherapy followed by radiotherapy (especially with the combination of cisplatin and 5-fluorouracil infusion for three courses) resulted in a 5-year survival rate of up to 55% in patients with stage IV disease.
  • Total treatment with concurrent chemoradiotherapy followed by adjuvant cisplatin and 5-fluorouracil infusion resulted in 5-year survival rate of approximately 75%.
  • Reversing the sequence of treatment by giving chemotherapy followed by concurrent chemoradiotherapy may improve the 5-year survival to up to 90%.
  • In patients with recurrent disease or systemic metastases, the chances of salvage and long remission (many years) is approximately 15% to 20% with the use of adequate and effective chemotherapy.
  • [MeSH-major] Carcinoma. Carcinoma, Squamous Cell. Nasopharyngeal Neoplasms
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Carcinogens, Environmental / adverse effects. Combined Modality Therapy / methods. Dose Fractionation. Epstein-Barr Virus Infections / complications. Humans. Neoplasm Staging. Neoplastic Processes. Radiotherapy / methods. Survival Analysis

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  • (PMID = 12057084.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Carcinogens, Environmental
  • [Number-of-references] 38
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53. 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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54. 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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55. Downing NL, Wolden S, Wong P, Petrik DW, Hara W, Le QT: Comparison of treatment results between adult and juvenile nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2009 Nov 15;75(4):1064-70
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  • [Title] Comparison of treatment results between adult and juvenile nasopharyngeal carcinoma.
  • PURPOSE: Nasopharyngeal carcinoma (NPC) has a bimodal age distribution.
  • This study examined the treatment results between adult (aNPC) and juvenile NPC (jNPC) patients for future treatment considerations in jNPC.
  • The patients had received a median dose of 66 Gy of external beam radiotherapy and 72% underwent chemotherapy.
  • RESULTS: The jNPC patients presented with more advance stages than did the aNPC patients (92% vs. 67% Stage III-IV, p = .006).
  • Univariate analysis for OS revealed that age group, nodal classification, and chemotherapy use were significant prognostic factors.
  • Age group remained significant for OS on multivariate analysis, after adjusting for N classification and treatment.
  • CONCLUSION: Despite more advance stage at presentation, jNPC patients had better survival than did aNPC patients.
  • Future treatment strategies should take into consideration the long-term complications in these young patients.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Age Factors. Analysis of Variance. Female. Humans. Male. Prognosis. Radiotherapy Dosage. Retrospective Studies. Treatment Outcome. Young Adult

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2010 Apr;76(5):1600-1; author reply 1601 [20338485.001]
  • (PMID = 19327901.001).
  • [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] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] United States
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56. Sumitsawan Y, Chaiyasate S, Chitapanarux I, Anansuthiwara M, Roongrotwattanasiri K, Vaseenon V, Tooncam H: Late complications of radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx; 2009 Apr;36(2):205-9
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  • [Title] Late complications of radiotherapy for nasopharyngeal carcinoma.
  • OBJECTIVE: To evaluate and assemble late complications of radiotherapy in cases of nasopharyngeal cancer.
  • The mean pre- and post-treatment body mass indexes (BMI) were 22.5+/-4 (15-35.6), and 19.8+/-3.2 (12.9-34.5; P<0.05).
  • Most of the patients (92%) had undifferentiated (50.5%) and poorly differentiated (41.5%) squamous cell carcinoma.
  • Eighty-eight percent of the patients were in Stage III and IV.
  • Chemotherapy was given to 145 patients (72.5%).
  • The mean post-radiation period in the added chemotherapy group was lower than the group treated with radiation alone (2.9+/-2.7 years vs. 5.4+/-4.4 years, P<.05).
  • Added chemotherapy increased the complication severity significantly for the skin (P<0.05).
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy. Radiation Injuries / etiology
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy. Chemotherapy, Adjuvant. Child. Cohort Studies. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Quality of Life. Radiotherapy Dosage. Young Adult

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  • (PMID = 18635325.001).
  • [ISSN] 1879-1476
  • [Journal-full-title] Auris, nasus, larynx
  • [ISO-abbreviation] Auris Nasus Larynx
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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57. Gil Z, Fliss DM: Contemporary management of head and neck cancers. Isr Med Assoc J; 2009 May;11(5):296-300
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  • Head and neck cancer is the sixth most common cancer worldwide.
  • HNCs can originate in the skin or soft tissue, in the upper aerodigestive tracts (oral cavity, oropharynx, hypopharynx, larynx, nasopharynx, paranasal sinuses, salivary glands), or in the thyroid.
  • In each of these sites, tumors vary not only by the primary site but also by pathophysiology, biological behavior, and sensitivity to radiotherapy or chemotherapy.
  • The main goals of therapy are ablation of the cancer while minimizing morbidity and preserving function and cosmesis.
  • Early-stage HNC (stage I and II) should be managed with a single modality, and advanced tumors (stage III and IV) with multimodality therapy.
  • Treatment should be directed to the primary tumor and the area of its lymphatic drainage--the neck lymph nodes.
  • [MeSH-major] Head and Neck Neoplasms / therapy
  • [MeSH-minor] Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Chemotherapy, Adjuvant. Combined Modality Therapy. Humans. Laryngeal Neoplasms / diagnosis. Laryngeal Neoplasms / pathology. Laryngeal Neoplasms / therapy. Lymphatic Metastasis. Neck Dissection. Prognosis. Quality of Life. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 19637508.001).
  • [ISSN] 1565-1088
  • [Journal-full-title] The Israel Medical Association journal : IMAJ
  • [ISO-abbreviation] Isr. Med. Assoc. J.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Israel
  • [Number-of-references] 29
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58. 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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59. 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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60. Si Y, Zhang Z, Chen S, Tang F, Zhou R, Qin Y, Huang B: [Clinical study on modified transpalatine radical operation for carcinoma of nasopharynx]. Lin Chuang Er Bi Yan Hou Ke Za Zhi; 2002 Mar;16(3):120-2
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  • [Title] [Clinical study on modified transpalatine radical operation for carcinoma of nasopharynx].
  • OBJECTIVE: To evaluate the method of transpalatine surgical treatment of carcinoma of nasopharynx (NPC).
  • METHOD: The artery palatine major was protected and the resection domain of primary lesion of NPC was expanded by modified hard palatine incision.
  • Preventive radiotherapy and routine chemotherapy was given after the operation.
  • RESULT: Twelve patients were in our report, five of II stage and seven of III stage.
  • CONCLUSION: Without affecting the healing of the incision, expanding the resective domain of primary lesion of NPC is possible by modified hard palatine incision, and the occurrence of sequelae of radiotherapy can be reduced by giving preventive radiotherapy.
  • [MeSH-major] Nasopharyngeal Neoplasms / surgery. Palate, Hard / surgery
  • [MeSH-minor] Adult. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoadjuvant Therapy

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  • (PMID = 15510664.001).
  • [Journal-full-title] Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology
  • [ISO-abbreviation] Lin Chuang Er Bi Yan Hou Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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61. Turen S, Ozyar E, Altundag K, Gullu I, Atahan IL: Serum lactate dehydrogenase level is a prognostic factor in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. Cancer Invest; 2007 Aug;25(5):315-21
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  • [Title] Serum lactate dehydrogenase level is a prognostic factor in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.
  • We investigated the treatment results and probable prognostic factors in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) treated with neoadjuvant chemotherapy (NCT) plus conventional radiotherapy (RT) or concomitant chemoradiotherapy (CCRT) at our hospital.
  • We retrospectively evaluated 61 patients (48 males, 13 females) with locoregionally advanced NPC treated either with 2 cycles of NCT plus RT (Group A, 37 patients) or with three cycles of NCT plus CCRT (Group B, 24 patients) between September 1995 and October 2002.
  • According to the AJCC 1997 classification system, 19 patients had Stage III disease and 42 had Stage IV.
  • Total RT doses were ranged between 59.4-71.6 Gy (median: 66.2 Gy).
  • Patient sex, histopathologic subtype, T status, ECOG performance status, stage, serum lactate dehydrogenase (LDH) level, and cranial nerve involvement at diagnosis were comparable in the 2 groups.
  • There were statistically significant differences between median follow-up times and N status for the 2 groups.
  • Univariate analysis revealed the pretreatment LDH level as the only statistically significant prognostic factor for disease-free survival (DFS) and overall survival (OS).
  • Multivariate analysis also revealed that high serum LDH level was the only independent risk factor that predicted OS.
  • Our study demonstrated that high serum LDH level is the only independent unfavorable risk factor for OS in patients with locoregionally advanced NPC who were treated with NCT plus RT or CCRT.
  • [MeSH-major] L-Lactate Dehydrogenase / blood. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Analysis. Time Factors

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  • (PMID = 17661206.001).
  • [ISSN] 0735-7907
  • [Journal-full-title] Cancer investigation
  • [ISO-abbreviation] Cancer Invest.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] EC 1.1.1.27 / L-Lactate Dehydrogenase
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62. 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).
  • Except for 1 patient suffered from grade 2 vomiting, no patient developed other adverse events in combination group.
  • 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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63. Liang Y, Gao JM, Hu WH, Gao YH, Xie FY: [Long-term efficacy of induction chemotherapy plus concurrent radiochemotherapy on advanced nasopharyngeal carcinoma]. Ai Zheng; 2007 Aug;26(8):885-9
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  • [Title] [Long-term efficacy of induction chemotherapy plus concurrent radiochemotherapy on advanced nasopharyngeal carcinoma].
  • BACKGROUND & OBJECTIVE: Induction chemotherapy plus concurrent radiochemotherapy may prolong disease-free and overall survival of advanced nasopharyngeal carcinoma (NPC) patients.
  • This study was to compare the long-term efficacy of induction chemotherapy plus concurrent radiochemotherapy and radiotherapy alone on advanced NPC.
  • METHODS: Clinical data of 535 advanced NPC patients, treated in Cancer Center of Sun Yat-sen University from Jan.
  • Of the 535 patients, 75 were treated with 3-5 cycles of induction and concomitant chemotherapy of PF regimen (cisplatin combined 5-fluorouracil) plus radiotherapy, 460 were treated with radiotherapy alone.
  • For the patients with stage III tumors, the median overall and disease-free survival term were significantly longer in radiochemotherapy group than in radiotherapy group (94.5 months vs. 85.1 months, 89.5 months vs. 82.9 months, P<0.05).
  • For the patients with stage IVa tumors, the same results were obtained (82.4 months vs. 44.4 months, 69.6 months vs. 40.3 months, P<0.05).
  • Cox regression analysis showed that clinical stage and chemotherapy were dependent prognostic factors of advanced NPC.
  • CONCLUSION: Induction chemotherapy plus concurrent radiochemotherapy could prolong the survival of patients with advanced NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / therapy. Nasopharyngeal Neoplasms / therapy. Radiotherapy, High-Energy
  • [MeSH-minor] Cisplatin / therapeutic use. Combined Modality Therapy. Disease-Free Survival. Dose Fractionation. Female. Fluorouracil / therapeutic use. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Radiation Dosage. Remission Induction. Survival Rate

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  • (PMID = 17697553.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; CF regimen
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64. 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.
  • 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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65. Prosnitz RG, Yao B, Farrell CL, Clough R, Brizel DM: Pretreatment anemia is correlated with the reduced effectiveness of radiation and concurrent chemotherapy in advanced head and neck cancer. Int J Radiat Oncol Biol Phys; 2005 Mar 15;61(4):1087-95
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  • [Title] Pretreatment anemia is correlated with the reduced effectiveness of radiation and concurrent chemotherapy in advanced head and neck cancer.
  • PURPOSE: Pretreatment anemia is an adverse prognostic variable in squamous cell head-and-neck cancer (HNC) patients treated with radiotherapy (RT) alone.
  • Tumor hypoxia is an adverse parameter for treatment with RT alone or with RT and concurrent chemotherapy (CCT).
  • This study was performed to evaluate whether pretreatment Hgb less than 13 g/dL was correlated with treatment outcome in patients with advanced HNC treated with a uniform regimen of RT/CCT.
  • METHODS AND MATERIALS: The study population consisted of patients with AJCC Stage III or IV, M0 HNC who were treated with 70 to 72.5 Gy accelerated hyperfractionated RT (1.25 Gy b.i.d.) and CCT consisting of 2 cycles of CDDP (12-20 mg/m(2)/d x 5 days) and continuous infusion 5-FU (600 mg/m(2)/d x 5 days) during Week 1 and Week 6.
  • RT/CCT was delivered as standard therapy from 1996 to 2000.
  • Primary tumor sites included oropharynx (43%), hypopharynx/larynx (36%), oral cavity (9%), and nasopharynx (6%).
  • Seventy-eight percent of the patients with Hgb 13 g/dL or higher and 92% of the patients with Hgb less than 13 g/dL had a primary tumor stage of T3 or T4 (p = 0.01).
  • The therapeutic effect of anemia correction is being evaluated in prospective trials.
  • [MeSH-major] Anemia / complications. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / radiotherapy. Hemoglobins / metabolism
  • [MeSH-minor] Adult. Aged. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Radiotherapy Dosage. Treatment Failure

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  • (PMID = 15752888.001).
  • [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] 0 / Hemoglobins; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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66. 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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67. 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.
  • 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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68. Ozyar E, Selek U, Laskar S, Uzel O, Anacak Y, Ben-Arush M, Polychronopoulou S, Akman F, Wolden SL, Sarihan S, Miller RC, Ozsahin M, Abacioğlu U, Martin M, Caloglu M, Scandolaro L, Szutowicz E, Atahan IL: Treatment results of 165 pediatric patients with non-metastatic nasopharyngeal carcinoma: a Rare Cancer Network study. Radiother Oncol; 2006 Oct;81(1):39-46
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  • [Title] Treatment results of 165 pediatric patients with non-metastatic nasopharyngeal carcinoma: a Rare Cancer Network study.
  • PURPOSE: This Rare Cancer Network (RCN) study was performed in pediatric nasopharyngeal carcinoma (PNPC) patients to evaluate the optimal dose of radiotherapy and to determine prognostic factors.
  • PATIENTS AND METHODS: The study included 165 patients with the diagnosis of PNPC treated between 1978 and 2003.
  • There were 3 (1.8%) patients with stage I, 1 (0.6%) with IIA, 10 (6.1%) with IIB, 60 (36.4%) with III, 44 (26.7%) with IVA, and 47 (29%) with IVB disease.
  • While 21 (12.7%) patients were treated with radiotherapy (RT) alone, 144 (87.3%) received chemotherapy and RT.
  • The median follow-up time was 48 months.
  • In multivariate analysis, unfavorable factors were age >14 years for LRC (p=0.04); male gender for DMFS (p=0.03); T3/T4 disease for LRFS (p=0.01); and N3 disease for DFS (p=0.002) and OS (p=0.002); EBRT dose of less than 66 Gy for LRFS (p=0.02) and LRRFS (p=0.0028); and patients treated with RT alone for LRFS (p=0.0001), LRRFS (p=0.007) and DFS (p=0.02).
  • CONCLUSION: Our results support the current practice of using combined radiation and chemotherapy for optimal treatment of NPC.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Rare Diseases / radiotherapy
  • [MeSH-minor] Adolescent. Age Factors. Child. Combined Modality Therapy / adverse effects. Combined Modality Therapy / methods. Disease-Free Survival. Dose Fractionation. Epidemiologic Methods. Female. Humans. Male. Neoplasm Recurrence, Local. Prognosis. Sex Factors. Treatment Outcome


69. Gupta T, Agarwal JP, Ghosh-Laskar S, Parikh PM, D'Cruz AK, Dinshaw KA: Radical radiotherapy with concurrent weekly cisplatin in loco-regionally advanced squamous cell carcinoma of the head and neck: a single-institution experience. Head Neck Oncol; 2009;1:17
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  • [Title] Radical radiotherapy with concurrent weekly cisplatin in loco-regionally advanced squamous cell carcinoma of the head and neck: a single-institution experience.
  • BACKGROUND: The dominant pattern of failure for squamous cell carcinoma of head and neck remains loco-regional, although distant metastases are now being increasingly documented.
  • Radical radiotherapy with concurrent chemotherapy is contemporary standard of care in the non-surgical management of these loco-regionally advanced cancers, based on large randomized controlled trials utilizing high-dose cisplatin (80-100 mg/m2) cycled every three-weekly during definitive radiotherapy.
  • METHODS: Outcome data of patients with Stage III & IV head and neck squamous cell carcinoma, excluding nasopharynx, planned for radical radiotherapy (66-70 Gy) with concurrent weekly cisplatin (30 mg/m2) treated in a single unit between 1996-2004 was extracted.
  • The median radiotherapy dose was 70 Gy (range 7.2-72 Gy) and median number of chemotherapy cycles was 6 (range 1-7).
  • Acute grade 3 or worse mucositis and dermatitis was seen in 77 (29%) and 92 (35%) patients respectively, essentially in patients receiving doses > or = 66 Gy and 6 or more cycles of chemotherapy.
  • Stage grouping, primary site, and intensity of treatment were significant predictors of loco-regional control and disease free survival.
  • CONCLUSION: Radical radiotherapy with concurrent weekly cisplatin has moderate efficacy and acceptable acute toxicity with potential to be an optimal regimen in loco-regionally advanced squamous cell carcinoma of the head and neck, particularly in limited-resource settings.
  • Stage grouping, primary site, and treatment intensity are important determinants of outcome.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / therapy. Cisplatin / therapeutic use. Head and Neck Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Proportional Hazards Models. Radiotherapy Dosage

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  • (PMID = 19527507.001).
  • [ISSN] 1758-3284
  • [Journal-full-title] Head & neck oncology
  • [ISO-abbreviation] Head Neck Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2702367
  • [General-notes] NLM/ Original DateCompleted: 20100629
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70. 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).
  • The 3-year progression-free survival was 75.6% and the 3-year overall survival was 86.1%.
  • 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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71. Yu Z, Luo W, Zhou QC, Zhang QH, Kang DH, Liu MZ: [Impact of changing gross tumor volume delineation of intensity-modulated radiotherapy on the dose distribution and clinical treatment outcome after induction chemotherapy for the primary locoregionally advanced nasopharyngeal carcinoma]. Ai Zheng; 2009 Nov;28(11):1132-7
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  • [Title] [Impact of changing gross tumor volume delineation of intensity-modulated radiotherapy on the dose distribution and clinical treatment outcome after induction chemotherapy for the primary locoregionally advanced nasopharyngeal carcinoma].
  • BACKGROUND AND OBJECTIVE: The gross tumor volume (GTV) obviously reduces after induction chemotherapy (IC) for primary locoregionally advanced nasopharyngeal carcinoma (NPC).
  • This study was to investigate the impact of changing gross tumor volume delineation on the dose distribution and clinical treatment outcome after IC.
  • METHODS: From January 2008 to April 2009, 24 patients with Stage III-IVb primary locoregionally advanced NPC were treated with TPF regimen IC followed by intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy .
  • The primary GTVs were delineated into two parts: the post-IC primary GTV (GTVpost-IC-NP), and the region of pre-IC primary GTV minus GTVpost-IC-NP (GTVpre-post-IC-NP).
  • The dose distributions of two plans with GTVpost-IC-NP or pre-IC primary GTV were assessed by analyzing ten cases.
  • The clinical treatment outcome and toxicity of all patients were observed.
  • The high dose region was also smaller after IC (volumes covered by 64.4 Gy were 422.9 cm3 vs. 457.9 cm3, P=0.003; 274.2 cm(3) vs.334.5 cm(3) by 68 Gy, P=0.041).
  • The toxicity of following IMRT with concurrent chemotherapy was similar to that of IMRT with concurrent chemotherapy alone.
  • With median follow-up of 9 months, the locoregionally control rate was 100% and only one patient presented metastasis 15 months after treatment.
  • The following IMRT with GTVpost-IC-NP plan reduced the high dose region, which didn't add toxicity while had excellent short-term treatment outcome.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated / methods. Tumor Burden
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / adverse effects. Cisplatin / therapeutic use. Female. Fluorouracil / adverse effects. Fluorouracil / therapeutic use. Follow-Up Studies. Humans. Lymph Nodes / pathology. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Neutropenia / chemically induced. Neutropenia / etiology. Radiodermatitis / etiology. Radiotherapy Dosage. Remission Induction. Taxoids / adverse effects. Taxoids / therapeutic use. Xerostomia / chemically induced. Xerostomia / etiology

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  • (PMID = 19895731.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Taxoids; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; TPF protocol
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72. 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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73. Nakamura RA, Novaes PE, Antoneli CB, Fogaroli RC, Pellizzon AC, Ferrigno R, Maia MA, Salvajoli JV, Pereira AJ, Nishimoto IN: High-dose-rate brachytherapy as part of a multidisciplinary treatment of nasopharyngeal lymphoepithelioma in childhood. Cancer; 2005 Aug 1;104(3):525-31
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  • [Title] High-dose-rate brachytherapy as part of a multidisciplinary treatment of nasopharyngeal lymphoepithelioma in childhood.
  • BACKGROUND: Nasopharyngeal carcinoma in childhood is rare.
  • Radiochemotherapy is considered the standard treatment and yields increased survival and local control rates.
  • In this article, the authors report on the results from the multidisciplinary treatment of pediatric patients who had nasopharyngeal lymphoepithelioma with radiochemotherapy, including high-dose-rate brachytherapy of the primary tumor site.
  • METHODS: Between May 1992 and May 2000, 16 children with nasopharyngeal lymphoepithelioma received neoadjuvant chemotherapy, conventional external beam radiotherapy, high-dose-rate brachytherapy, and adjuvant chemotherapy.
  • Patient distribution according to clinical disease stage was as follows: Stage III, 1 patient; Stage IVA, 5 patients; Stage IVB, 9 patients; and Stage IVC, 1 patient.
  • Three cycles of neoadjuvant and adjuvant chemotherapy in 3-week intervals were administered with cyclophosphamide, vincristine, doxorubicin, and cisplatin.
  • The median doses of external beam radiotherapy to the primary tumor, positive lymph nodes, and subclinical areas of disease were 55 grays (Gy), 55 Gy, and 45 Gy, respectively.
  • Children received 2 insertions of high-dose-rate brachytherapy at 5 Gy per insertion: These were performed with metallic applicators inserted through the transnasal access under local anesthesia.
  • At the time of last follow-up, 13 patients were alive without disease, 2 patients had died of disease, and 1 patient had died of treatment-related cardiac failure.
  • Chemotherapy-related and radiotherapy-related acute toxicity was relevant but tolerable.
  • CONCLUSIONS: In the current study, it was shown that the treatment was effective in the control of both local and distant disease, although there was relevant acute and late toxicity.
  • Close follow-up of these patients was necessary to evaluate the significance of treatment-related late effects and their impact on quality of life.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy. Carcinoma, Squamous Cell / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Child. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Follow-Up Studies. Humans. Male. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. Quality of Life. Retrospective Studies. Survival Rate. Vincristine / administration & dosage

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  • [Copyright] (c) 2005 American Cancer Society.
  • (PMID = 15986481.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
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74. Palazzi M, Guzzo M, Bossi P, Tomatis S, Cerrotta A, Cantú G, Locati LD, Licitra L: Regionally advanced nasopharyngeal carcinoma: long-term outcome after sequential chemotherapy and radiotherapy. Tumori; 2004 Jan-Feb;90(1):60-5
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  • [Title] Regionally advanced nasopharyngeal carcinoma: long-term outcome after sequential chemotherapy and radiotherapy.
  • AIMS AND BACKGROUND: To evaluate the long-term clinical outcome of 61 patients with regionally advanced nasopharyngeal carcinoma treated with sequential chemotherapy and radiotherapy within a phase II trial.
  • METHODS: The trial evaluated a combined modality regimen including 3 cycles of induction polychemotherapy (epirubicin 70 mg/m2 d1, and cisplatin 100 mg/m2 d1, both recycled every 3 weeks) followed by definitive radiotherapy to the primary site (64-70 Gy) and the neck (50-70 Gy).
  • Patients included in the trial had pathologically confirmed nasopharyngeal carcinoma; stage (UICC 1987) T-any, N2-3, M0; ECOG performance status 0-1.
  • Sixty-one patients were enrolled between 1990 and 1996; stage according to UICC 1997 was IIb in 8%, III in 36% and IV in 56% of the patients; histology was WHO type 1-2 in 11% and WHO type 3 in 89% of cases.
  • RESULTS: Clinical failure has been observed in 30 patients (49%): initial failure, observed within the third year of follow-up in all but one case, was local alone in 6 (20%), regional alone in 10 (33%), local and regional in 1 (3%), regional and distant in 1 (3%), and distant alone in 12 patients (40%).
  • Late effects of initial treatment, as evaluated in 30 patients surviving 5 years without relapse, were generally acceptable, but some degree of xerostomia, dental damage, trismus and hearing loss were reported by a significant proportion of patients (respectively 100%, 88%, 76% and 86%).
  • CONCLUSIONS: In our experience, long-term clinical cure of regionally advanced nasopharyngeal carcinoma was obtained in 51% of cases treated with chemotherapy and radiotherapy.
  • Salvage treatments (neck surgery, local re-irradiation) are worthy, as they increase the cure rate by approximately 10%, raising 5-year survival to over 60%.
  • Late effects are significant, calling for refinements in radiation technique, better integration with chemotherapy to possibly decrease the need for higher radiation dose, and/or use of effective radioprotectants.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Male. Radiotherapy Dosage. Radiotherapy, Adjuvant. Remission Induction. Survival Analysis. Time Factors. Treatment Failure. Treatment Outcome

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  • (PMID = 15143974.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
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75. 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.
  • RESULTS: median age, 45; 27% Asian; 68% male; 64% WHO III.
  • 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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76. 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.
  • The 3-year local control rate was 100%, the freedom from distant metastasis rate was 69%, the progression-free survival rate was 71%, and the overall survival rate was 75%.
  • 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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77. Chen K, Jiang Y, Wen H: [Clinical study on treatment of nasopharyngeal carcinoma by radio- and chemotherapy with supplementary moxibustion on Shenque point]. Zhongguo Zhong Xi Yi Jie He Za Zhi; 2000 Oct;20(10):733-5
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  • [Title] [Clinical study on treatment of nasopharyngeal carcinoma by radio- and chemotherapy with supplementary moxibustion on Shenque point].
  • OBJECTIVE: To evaluate the effect of supplementary moxibustion in treating III, IV a stage nasopharyngeal carcinoma (NPC) with radio- and chemotherapy.
  • METHODS: Fifty-six cases of NPC were randomly divided into two groups, 28 in each group.
  • They were treated with radiotherapy in routine or chemotherapy adopting AD protocol.
  • Salt-separated moxibustion on Shenque (Ren 8) point was given to the treated group from beginning of radio- and chemotherapy for 30 times as one therapeutic course.
  • RESULTS: The remission rate in the two groups after radio- and chemotherapy was not different significantly.
  • The 5-year local control rates of NPC and cervical lymphnode were 85.7% and 85.0% in the treated group, which were higher than those in the control group (78.6% and 78.9%).
  • After radio- and chemotherapy, the blood content of malonyldialdehyde (MDA), middle molecular substance and sulfhydryl reduced the SOD activity ascended in the treated group, the difference was significant as compared with those in the control group (P < 0.05, P < 0.01).
  • CONCLUSION: The supplementary moxibustion on Shenque point could obviously reduce the toxic side-effect of advanced NPC patients treated with radio- and chemotherapy.

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  • (PMID = 11938806.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin
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78. 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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79. Hong RL, Ting LL, Ko JY, Hsu MM, Sheen TS, Lou PJ, Wang CC, Chung NN, Lui LT: Induction chemotherapy with mitomycin, epirubicin, cisplatin, fluorouracil, and leucovorin followed by radiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol; 2001 Dec 01;19(23):4305-13
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  • [Title] Induction chemotherapy with mitomycin, epirubicin, cisplatin, fluorouracil, and leucovorin followed by radiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma.
  • PURPOSE: Survival in advanced nasopharyngeal carcinoma (NPC) is compromised by distant metastasis.
  • Because mitomycin is active against hypoxic and G0 cells, which may help to eradicate micrometastasis, we investigated the effect of mitomycin-containing cisplatin-based induction chemotherapy.
  • PATIENTS AND METHODS: Recruited for this study were American Joint Committee on Cancer (AJCC) 1992 staging system stage IV NPC patients with the following adverse features: obvious intracranial invasion, supraclavicular or bilateral neck lymph node metastasis, large neck node (> 6 cm), or elevated serum lactate dehydrogenase (LDH) level.
  • Patients were given three cycles of chemotherapy before radiotherapy.
  • The chemotherapy comprised a 3-week cycle of mitomycin, epirubicin, and cisplatin on day 1 and fluorouracil and leucovorin on day 8 (MEPFL).
  • By Cox multivariate analysis, high pretreatment serum LDH level (P = .04) and neck nodal enlargement before radiotherapy (P = .001) were adverse prognostic factors of survival.
  • CONCLUSION: The good 5-year survival of N3 disease supports the effectiveness of induction MEPFL in the primary treatment of advanced NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Cisplatin / administration & dosage. Disease-Free Survival. Drug Administration Schedule. Epirubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Lymphatic Metastasis. Male. Middle Aged. Mitomycin / administration & dosage. Neoadjuvant Therapy. Neoplasm Recurrence, Local. Neoplasm Staging. Survival Analysis. Taiwan. Treatment Outcome

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  • (PMID = 11731513.001).
  • [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 III; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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80. Hu QY, Liu P, Wang L, Fu ZF: [Concurrent chemoradiotherapy followed by adjuvant chemotherapy for stage III-IVa nasopharyngeal carcinoma]. Ai Zheng; 2007 Apr;26(4):394-7
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  • [Title] [Concurrent chemoradiotherapy followed by adjuvant chemotherapy for stage III-IVa nasopharyngeal carcinoma].
  • BACKGROUND & OBJECTIVE: Most studies on chemoradiotherapy for advanced nasopharyngeal carcinoma (NPC) showed that induction chemotherapy before radiotherapy could not improve the survival of the patients, but the effect of adjuvant chemotherapy after radiotherapy on advanced NPC is uncertain.
  • A study showed that concurrent chemoradiotherapy could improve the prognosis of advanced NPC.
  • This study was to evaluate the efficacy of concurrent chemoradiotherapy followed by adjuvant chemotherapy on stage III-IVa nasopharyngeal carcinoma (NPC).
  • METHODS: A total of 80 patients with stage III-IVa NPC were randomized into test group (40 patients) and control group (40 patients).
  • Test group received concurrent chemotherapy of weekly cisplatin (25 mg/m2) for 6 weeks, and conventional radiotherapy of standard fractionation at 2 Gy/day to a total of 70 Gy to the nasopharynx, followed by adjuvant chemotherapy of cisplatin (25 mg/m2) and 5-fluorouracil (1000 mg/m2) daily for 3 days and repeated every 3 weeks for 3 cycles.
  • RESULTS: After treatment, 34 patients in test group and 32 in control group achieved complete remission (CR) (P>0.05); the CR rate of neck lymph node was significantly higher in test group than in control group (92.5% vs. 75.0%, P<0.05).
  • Grade III mucositis was more frequently observed in test group than in control group (75.0% vs. 25.0%, P<0.01).
  • CONCLUSION: Concurrent chemoradiotherapy followed by adjuvant chemotherapy could improve the CR rate of neck lymph node, overall survival, and disease-free survival of stage III-IVa NPC patients, suppress distant metastasis, but increase the risk of grade III mucositis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / therapy. Nasopharyngeal Neoplasms / therapy. Radiotherapy, High-Energy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Dose Fractionation. Female. Fluorouracil / administration & dosage. Humans. Lymphatic Metastasis. Male. Middle Aged. Mucositis / chemically induced. Neoplasm Staging. Remission Induction. Survival Rate

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  • (PMID = 17430659.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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81. Mostafa E, Nasar MN, Rabie NA, Ibrahim SA, Barakat HM, Rabie AN: Induction chemotherapy with paclitaxel and cisplatin, followed by concomitant cisplatin and radiotherapy for the treatment of locally advanced nasopharyngeal carcinoma. J Egypt Natl Canc Inst; 2006 Dec;18(4):348-56
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  • [Title] Induction chemotherapy with paclitaxel and cisplatin, followed by concomitant cisplatin and radiotherapy for the treatment of locally advanced nasopharyngeal carcinoma.
  • PURPOSE: To evaluate the efficacy and outcome of neoadjuvant paclitaxel and cisplatin chemotherapy followed by concurrent cisplatin and irradiation in patients with locally advanced nasopharyngeal (NP) squamous cell carcinoma.
  • PATIENTS AND METHODS: The trial included 36 patients with locally advanced nasopharyngeal squamous carcinoma presented to Radiation Oncology and Otolaryngology departments-Ain Shams university hospitals, and Sohag Cancer Center between November 2002 and March 2006.
  • Eligible patients were treated first with three cycles of induction chemotherapy (IC), paclitaxel (175 mg/m2 on day 1) and cisplatin (80 mg/m2 on day 1) followed by concomitant conventionally fractionated radiation (70 Gy in 2 Gy fractions) and cisplatin 20-mg/m2/day on days 1- 5, 22-26 and 43-47 of the radiation therapy.
  • Survival and PFS were significantly better for patients with smaller tumor volume (stage III), compared with patients with stage IV.
  • CONCLUSIONS: IC followed by CCRT treatment program is feasible, tolerable and safe.
  • However combined treatment program have failed to improve survival rates over the historical result of CCRT trials.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / administration & dosage. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Paclitaxel / administration & dosage. Radiotherapy. Radiotherapy, Adjuvant
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant / adverse effects. Combined Modality Therapy. Disease Progression. Female. Humans. Male. Middle Aged. Patient Compliance. Survival Analysis. Treatment Outcome

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  • (PMID = 18301458.001).
  • [ISSN] 1110-0362
  • [Journal-full-title] Journal of the Egyptian National Cancer Institute
  • [ISO-abbreviation] J Egypt Natl Canc Inst
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] Egypt
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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82. 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.
  • 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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83. Rivera S, Keryer C, Busson P, Maingon P: [Nasopharyngeal carcinomas: from biology to clinic]. Cancer Radiother; 2005 Feb;9(1):55-68
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  • [Title] [Nasopharyngeal carcinomas: from biology to clinic].
  • [Transliterated title] Les carcinomes du nasopharynx: de la biologie à la clinique.
  • Nasopharyngeal carcinomas (NPC) are very different from other head and neck cancers because of their specific multifactorial etiology and their geographic distribution.
  • Epstein-Barr Virus (EBV) is implicated in oncogenesis of NPC in association with genetic alterations such as inactivation of the p16/Ink4, p19/ARF, RASSF1 or Blu genes.
  • Tumoral tissues include a very abundant characteristic lymphoid infiltrate.
  • Inflammatory cytokines are produced by both malignant and infiltrating cells.
  • Serological methods and detection of circulating viral DNA are expected to become useful for early detection of relapse and on a longer term for primary screening.
  • NPC are often diagnosed at a late stage because patients may remain asymptomatic for a long time.
  • Computed tomography (CT scan) and magnetic resonance imaging (MRI) are complementary for the initial evaluation.
  • Positron emission tomography (PET) is efficient for the evaluation of treatment efficiency and detection of relapses.
  • Treatment is based on radiotherapy and chemotherapy.
  • Their optimal use needs to be evaluated by phase III trials but positive results have been obtained by concomitant association of radiotherapy and chemotherapy.
  • Targeted therapies are being studied with strategies based on disruption of viral latency, use of replicative adenoviruses or anti-tumor vaccination.
  • [MeSH-major] Carcinoma / physiopathology. Nasopharyngeal Neoplasms / physiopathology
  • [MeSH-minor] Cell Transformation, Neoplastic. DNA, Viral / analysis. Diagnosis, Differential. Epstein-Barr Virus Infections / complications. Genetic Predisposition to Disease. Humans. Positron-Emission Tomography. Prognosis. Risk Factors. Tomography, X-Ray Computed

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  • (PMID = 15804621.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / DNA, Viral
  • [Number-of-references] 119
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84. 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.
  • The 3-year actuarial progression-free survival and overall survival rates were 64% and 83%.
  • Induction chemotherapy followed by alternating chemo-radiotherapy is feasible and patients' compliance optimal.
  • This approach showed a very promising activity on locally advanced UNPC and merits to be investigated in phase III studies.
  • [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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85. Ozturk B, Buyukberber S, Akmansu M, Coskun U, Yamac D, Uner A, Yaman E, Yildiz R, Kaya AO, Bora H, Unsal D, Pak Y, Benekli M: The results of three different treatment modalities in patients with locally advanced nasopharyngeal carcinoma. Med Oncol; 2008;25(3):269-73
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  • [Title] The results of three different treatment modalities in patients with locally advanced nasopharyngeal carcinoma.
  • The aim of the study was to evaluate the toxicity and efficacy of 62 patients with locally advanced nasopharyngeal carcinoma (NPC) (stage III, IVA, IVB) treated by three different modalities.
  • In the group 2 (n=15), before the CCRT, neoadjuvant chemotherapy, consisting of intravenous cisplatin and docetaxel on day 1, every 3 weeks treatment cycles was administered.
  • In the group 3 (n=24), adjuvant chemotherapy, consisting of cisplatin on day 1 and 5-fluorouracil on day 1 to 5 every 3 weeks was used after CCRT.
  • There was no difference for age, sex, and stage among the groups.
  • A total of 82% patients completed planned chemotherapy concurrent with RT.
  • The treatment related adverse effects were mild or moderate in intensity.
  • There was no statistical difference between the groups regarding the treatment responses.
  • In our study, the efficacy and toxicity of neoadjuvant and/or adjuvant chemotherapy with CCRT and CCRT alone were found similar.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant / adverse effects. Cisplatin / adverse effects. Cisplatin / therapeutic use. Combined Modality Therapy. Disease Progression. Female. Fluorouracil / adverse effects. Fluorouracil / therapeutic use. Humans. Male. Middle Aged. Neoadjuvant Therapy / adverse effects. Neoplasm Staging. Radiotherapy, Adjuvant / adverse effects. Retrospective Studies. Taxoids / adverse effects. Taxoids / therapeutic use. Young Adult

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  • (PMID = 18080790.001).
  • [ISSN] 1357-0560
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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86. Selek U, Ozyar E, Ozyigit G, Varan A, Buyukpamukcu M, Atahan IL: Treatment results of 59 young patients with nasopharyngeal carcinoma. Int J Pediatr Otorhinolaryngol; 2005 Feb;69(2):201-7
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  • [Title] Treatment results of 59 young patients with nasopharyngeal carcinoma.
  • PURPOSE: To evaluate the outcome of patients </=30 years old with non-metastatic nasopharyngeal carcinoma and discover adverse prognostic factors.
  • MATERIALS AND METHODS: We performed a database search maintained by the Department of Radiation Oncology of Hacettepe University School of Medicine for patients with nasopharyngeal cancer who were </=30 years old at presentation.
  • There were 1 (2%) patient with stage I, 7 (12%) with stage IIb, 25 (42%) with stage III, 9 (15%) with stage IVA, and 17 (29%) with stage IVB.
  • Thirteen (22%) patients were stage T1, 16 (27%) were T2, 21 (36%) were T3, and 9 (15%) were T4.
  • While 12 (20.3%) patients were treated with EBRT alone, 47 (79.7%) received chemotherapy beside EBRT.
  • RESULTS: The median follow-up time for all patients was 46 months (range, 1-111 months).
  • While only 3 patients (5%) developed local recurrence (1/21 T3 and 2/9 T4 patients), 13 patients (22%) developed distant metastases (6/35 N1 and 2 and 7/17 N3 patients).
  • Four patients (6.7%) died due to the treatment related toxicity.
  • CONCLUSIONS: We suggest that RT combined with multiagent chemotherapy is effective in achieving satisfactory DFS and comparable OS in young patients with NPC.
  • All efforts towards decreasing late side effects of treatment should be encouraged in this long life expected group.
  • [MeSH-major] Carcinoma / mortality. Carcinoma / therapy. Nasopharyngeal Neoplasms / mortality. Nasopharyngeal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Antineoplastic Agents / therapeutic use. Brachytherapy. Chemotherapy, Adjuvant. Child. Cisplatin / therapeutic use. Databases as Topic. Disease-Free Survival. Dose Fractionation. Female. Humans. Male. Neoadjuvant Therapy. Neoplasm Metastasis. Neoplasm Recurrence, Local / radiotherapy. Retrospective Studies. Survival Rate. Turkey / epidemiology


87. Hatoum GF, Abitbol A, Elattar I, Lewin A, Troner M, Kronberg F, Raez LE, Weed D, Abdel-Wahab M: Radiation technique influence on percutaneous endoscopic gastrostomy tube dependence: Comparison between two radiation schemes. Head Neck; 2009 Jul;31(7):944-8
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  • METHODS: Stage III or IV locally advanced head and neck squamous cell carcinomas arising from the oral cavity, hypopharynx, oropharynx, nasopharynx, paranasal sinuses, or larynx were treated using hyperfractionation (A-3 protocol) or accelerated fractionation (A-4 protocol) with chemotherapy.
  • RESULTS: Thirty-five evaluable A-3 protocol patients, 14 evaluable A-4 protocol patients, and 6 patients treated per A-4 protocol guidelines, but without amifostine as they refused the medication, were included in the analysis.
  • Pretreatment characteristics, such as sex, age, race, T classification, N classification, American Joint Committee on Cancer (AJCC) stage, were compared between the 2 groups of patients.
  • The only significant difference between the 2 groups was AJCC stage.
  • Type of altered fractionation scheme may not influence PEG dependence in patients treated with similar protocols.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Dose Fractionation. Enteral Nutrition. Gastrostomy. Head and Neck Neoplasms / radiotherapy. Intubation, Gastrointestinal
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Endoscopy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Prospective Studies. Time Factors

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  • (PMID = 19309724.001).
  • [ISSN] 1097-0347
  • [Journal-full-title] Head & neck
  • [ISO-abbreviation] Head Neck
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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88. Palazzi M, Orlandi E, Bossi P, Pignoli E, Potepan P, Guzzo M, Franceschini M, Scaramellini G, Cantù G, Licitra L, Olmi P, Tomatis S: Further improvement in outcomes of nasopharyngeal carcinoma with optimized radiotherapy and induction plus concomitant chemotherapy: an update of the Milan experience. Int J Radiat Oncol Biol Phys; 2009 Jul 1;74(3):774-80
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  • [Title] Further improvement in outcomes of nasopharyngeal carcinoma with optimized radiotherapy and induction plus concomitant chemotherapy: an update of the Milan experience.
  • PURPOSE: To report the outcome of a consecutive series of patients with nonmetastatic nasopharyngeal carcinoma (NPC), focusing on the impact of treatment-related factors.
  • METHODS AND MATERIALS: Between 2000 and 2006, 87 patients with NPC were treated with either conventional (two- or three-dimensional) radiotherapy (RT) or with intensity-modulated RT (IMRT).
  • Of these patients, 81 (93%) received either concomitant CHT (24%) or both induction and concomitant chemotherapy (CHT) (69%).
  • Stage was III in 36% and IV in 39% of patients.
  • In Stage III to IV patients, distant control at 3 years was 56% in patients treated with concomitant CHT only and 92% in patients treated with both induction and concomitant CHT (p = 0.014).
  • At multivariate analysis, histology, N-stage, RT technique, and total RT dose had the strongest independent impact on DFS (p < 0.05).
  • CONCLUSIONS: Outcome of NPC has further improved in the study period compared with the previous decade, with a significant effect of RT technique optimization.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy / methods. Drug Administration Schedule. Epirubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Italy. Male. Middle Aged. Prospective Studies. Remission Induction. Taxoids / administration & dosage. Treatment Outcome. Young Adult

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  • (PMID = 19250771.001).
  • [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 / Taxoids; 15H5577CQD / docetaxel; 3Z8479ZZ5X / Epirubicin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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89. Feng ZF, Pan HL, Song HS, Liu ZM, Huang Y: [Radiotherapy with concurrent chemotherapy for treatment of advanced nasopharyngeal carcinoma]. Di Yi Jun Yi Da Xue Xue Bao; 2004 Jun;24(6):694-6
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  • [Title] [Radiotherapy with concurrent chemotherapy for treatment of advanced nasopharyngeal carcinoma].
  • OBJECTIVE: To evaluate the effect of radiotherapy combined with concurrent chemotherapy for the treatment of advanced nasopharyngeal carcinoma.
  • METHODS: From February 2001 to August 2003, 80 cases of nasopharyngeal carcinoma (stage III and IVa) were randomized into two groups to receive radiotherapy with concurrent chemotherapy (Group A, n=40) consisted of leucovorin (CF, 100 mg/m(2), days 1-5), 5-fluorouracil (5-Fu, 500 mg/m(2), days 1-5), cisplatin (DDP, 60 mg/m(2), day 1) for one course followed by another 4 weeks later, or radiotherapy alone (Group B, n=40).
  • In all cases, the radiotherapy followed the same protocol, with the nasopharyngeal (NP) total dose (DT) of 66-76 Gy given in 6.6-7.6 weeks, and cervical lymphnode (LN) DT of 60-72 Gy completed in 6.0-7.2 weeks.
  • RESULTS: All patients completed the treatment course, and the complete response rates of the primary lesions and cervical nodes in A and B groups were 77.5% and 60.0% (P>0.05) and 92.5% vs 70.0% (P<0.05), respectively, which were 92.5% vs 72.5% (P<0.05) and 100% vs 85.0% (P<0.05), respectively, 3 months after treatment.
  • CONCLUSION: Radiotherapy with concurrent chemotherapy can improve the elimination rate of advanced nasopharyngeal carcinoma, and can be completed in shorter treatment course in comparison with neoadjuvant chemotherapy before radiotherapy, eligible for clinical practice in the treatment of advanced nasopharyngeal carcinoma.
  • [MeSH-major] Nasopharyngeal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Prospective Studies. Radiotherapy / adverse effects

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  • (PMID = 15201093.001).
  • [ISSN] 1000-2588
  • [Journal-full-title] Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA
  • [ISO-abbreviation] Di Yi Jun Yi Da Xue Xue Bao
  • [Language] chi
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
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90. Lin JC, Liang WM, Jan JS, Jiang RS, Lin AC: Another way to estimate outcome of advanced nasopharyngeal carcinoma--is concurrent chemoradiotherapy adequate? Int J Radiat Oncol Biol Phys; 2004 Sep 1;60(1):156-64
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  • [Title] Another way to estimate outcome of advanced nasopharyngeal carcinoma--is concurrent chemoradiotherapy adequate?
  • PURPOSE: To evaluate a simple risk grouping system and determine whether concurrent chemoradiotherapy (CCRT) is adequate for patients with advanced nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: A total of 284 patients with 1992 American Joint Committee on Cancer (AJCC) Stage III to IV (M0) NPC were analyzed retrospectively.
  • (1) nodal size >6 cm, (2) supraclavicular node metastases, (3) 1992 AJCC stage T4N2, (4) multiple neck node metastases with 1 node >4 cm.
  • Survival analyses-including nasopharynx disease free (TS), neck disease free (NS), distant metastasis disease free (MS), overall survival (OS), and progression-free (PFS) survival curves-were compared between these three different classifications.
  • RESULTS: According to the 1992 AJCC staging system, 80.3% (228/284) of NPC patients are Stage IV, whereas only 19.7% are Stage III.
  • Most patients are downstaged by the 1997 AJCC staging system with 28.5% (81/284) Stage IV and 71.5% (203/284) Stage III/II.
  • Adding neoadjuvant and/or adjuvant chemotherapy would be a reasonable approach for high-risk patients.
  • Our risk grouping criteria are a simple and useful guide that will have important implications in the design of future therapeutic trials.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Combined Modality Therapy. Epidemiologic Methods. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies. Risk. Treatment Failure


91. Cengiz M, Ozyar E, Esassolak M, Altun M, Akmansu M, Sen M, Uzel O, Yavuz A, Dalmaz G, Uzal C, Hiçsönmez A, Sarihan S, Kaplan B, Atasoy BM, Ulutin C, Abacioğlu U, Demiral AN, Hayran M: Assessment of quality of life of nasopharyngeal carcinoma patients with EORTC QLQ-C30 and H&N-35 modules. Int J Radiat Oncol Biol Phys; 2005 Dec 1;63(5):1347-53
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  • [Title] Assessment of quality of life of nasopharyngeal carcinoma patients with EORTC QLQ-C30 and H&N-35 modules.
  • PURPOSE: The current study reports on long-term quality of life (QoL) status after conventional radiotherapy in 187 nasopharyngeal carcinoma patients from 14 centers in Turkey.
  • PATIENTS AND METHODS: Patients with the diagnosis of nasopharyngeal carcinoma, who were treated in 14 centers in Turkey with minimum 6 months of follow-up and were in complete remission, were asked to complete Turkish versions of EORTC QLQ-C30 questionnaire and the HN-35 module.
  • Each center participated with the required clinical data that included age at diagnosis, gender, symptoms on admission, follow-up period, treatment modalities, radiotherapy dose, and AJCC 1997 tumor stage.
  • A high score represents a higher response level.
  • Median follow-up time was 3.4 years (range, 6 months-24 years).
  • Beside external-beam radiotherapy, 59 patients underwent brachytherapy boost, 70 patients received concomitant chemotherapy, and 95 patients received adjuvant/neoadjuvant chemotherapy.
  • Most of the patients in the analysis (75%) were in advanced stage (Stage III, n = 85 [45.4%]; Stage IV, n = 55 [29%]).
  • Parameters that increased global health status were male gender, early-stage disease, and less than 4-year follow-up (p < 0.05).
  • Functional parameters were better in males and in early-stage disease.
  • Factors that yielded better symptom scores were short interval after treatment (10 scores), male gender (7 scores), and lower radiation dose (6 scores).
  • Neoadjuvant or adjuvant chemotherapy did not have any effect on QoL, whereas concomitant chemotherapy adversely affected 5 symptom scores.
  • CONCLUSION: Quality of life is adversely affected in our nasopharyngeal carcinoma patients treated with combined therapies.
  • The factors that adversely affect quality of life are advanced tumor stage, female gender, and long-term follow-up.
  • Further controlled studies to evaluate both preradiotherapy and postradiotherapy status are necessary to clarify the contribution of each treatment modality to QoL.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Quality of Life. Surveys and Questionnaires
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Female. Humans. Male. Middle Aged. Sex Factors. Statistics, Nonparametric. Turkey

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  • (PMID = 16169671.001).
  • [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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92. Ma BB, Chan AT: Recent perspectives in the role of chemotherapy in the management of advanced nasopharyngeal carcinoma. Cancer; 2005 Jan 1;103(1):22-31
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  • [Title] Recent perspectives in the role of chemotherapy in the management of advanced nasopharyngeal carcinoma.
  • BACKGROUND: Recent advances in the treatment of nasopharyngeal carcinoma (NPC) have transpired into better treatment outcomes for patients with locoregionally advanced NPC, and have broadened the chemotherapeutic options for patients with metastatic disease.
  • RESULTS: The results of two meta-analyses and at least six randomized trials supported a survival benefit with the use of concurrent chemotherapy (e.g., platinum, tegafur-uracil [UFT)] and standard fractionated radiotherapy (with or without adjuvant chemotherapy) in the management of patients with locoregionally advanced NPC (nonmetastatic Stage III/IV disease, according to the staging system of the International Union Against Cancer).
  • For those patients with metastatic NPC, platinum-based doublets using newer agents such as gemcitabine and the taxanes are reported to be better tolerated and can yield response rates comparable to those obtained with older, multidrug regimens.
  • CONCLUSIONS: The current study reviewed the latest literature and pertinent issues concerning the role of chemotherapy in the treatment of patients with metastatic and locoregionally advanced NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Nasopharyngeal Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Humans. Meta-Analysis as Topic. Randomized Controlled Trials as Topic. Survival Analysis

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  • (PMID = 15565580.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 64
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93. 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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  • [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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94. 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


95. Leung TW, Tung SY, Sze WK, Wong FC, Yuen KK, Lui CM, Lo SH, Ng TY, O SK: Treatment results of 1070 patients with nasopharyngeal carcinoma: an analysis of survival and failure patterns. Head Neck; 2005 Jul;27(7):555-65
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  • [Title] Treatment results of 1070 patients with nasopharyngeal carcinoma: an analysis of survival and failure patterns.
  • BACKGROUND: The aim of this analysis was to evaluate the outcomes of patients with nasopharyngeal carcinoma (NPC) treated primarily by external beam irradiation (ERT) and to explore for possible ways to improve the treatment results.
  • METHODS: One thousand seventy patients with nonmetastatic NPC treated from 1990 to 1998 were retrospectively analyzed.
  • The distribution according to the Union Internationale Contre le Cancer (UICC) (1997 edition) staging system at initial diagnosis was as follows: stage I, n = 113; stage IIA, n = 38; stage IIB, n = 360; stage III, n = 306; stage IVA, n = 136; stage IVB, n = 117; T1, n = 284; T2a, n = 88; T2b, n = 398; T3, n = 149; T4, n = 151; N0, n = 321; N1, n = 393; N2, n = 238; N3a, n = 29; N3b, n = 89.
  • Two hundred eight patients were given neoadjuvant chemotherapy.
  • RESULTS: The 5-year actuarial local failure-free survival, regional failure-free survival, distant metastasis-free survival, progression-free survival, cancer-specific survival, and overall survival rates were 80.9%, 93.3%, 77.2%, 62.7%, 71.4%, and 66.5%, respectively.
  • The distributions were as follow: stage I, 2.1% (two of 95); stage IIA, 5.7% (two of 35); stage IIB, 14.9% (45 of 302); stage III, 26.4% (62 of 235); stage IVA, 40% (40 of 100); stage IVB, 47.1% (40 of 85).
  • By studying these failure patterns, it is hoped that we could refine future treatments according to the failure patterns of patients with different risks of locoregional and distant failure.
  • [MeSH-major] Nasopharyngeal Neoplasms / mortality. Nasopharyngeal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Brachytherapy. Chemotherapy, Adjuvant. Female. Humans. Male. Middle Aged. Neck Dissection. Neoplasm Metastasis. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / prevention & control. Otorhinolaryngologic Surgical Procedures. Radiotherapy, Adjuvant. Retrospective Studies. Salvage Therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 15880410.001).
  • [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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96. Tian Y, Chua DT, Sham JS: [Concomitant chemo-radiotherapy for locoregionally advanced nasopharygeal carcinoma]. Zhonghua Zhong Liu Za Zhi; 2005 Jul;27(7):429-31
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  • [Title] [Concomitant chemo-radiotherapy for locoregionally advanced nasopharygeal carcinoma].
  • OBJECTIVE: To evaluate the efficacy and toxicity of concomitant chemo-radiotherapy (CCRT) followed by adjuvant chemotherapy (ACT) in Chinese patients with locoregionally advanced nasopharygeal carcinoma (NPC).
  • METHODS: Seventy-four patients with stage III and IV (UICC1997) were treated by Intergroup 0099 regimen, consisting of CCRT using cisplatin 100 mg/m(2) on D1, 22, and 43 of radiotherapy, followed by ACT using cisplatin 80 mg x m(-2) x d(-1) and 5-Fu 1 g x m(-2) x 4 d(-1) given from D71, 99, and 127.
  • All the patients were irradiated with conventional fractionation to a total dose of 68 Gy to the nasopharynx and 66 Gy to the neck.
  • The main grade 3/4 late complications were severe salivary gland toxicity (17 cases), ear injury (13 cases), and the neck skin/subcutaneous tissue disease (7 cases).
  • CONCLUSION: Compared with routine radiotherapy, the concomitant chemo-radiotherapy may improve the outcome of locoregionally advanced NPC in the Chinese patients, with higher incidence of severe acute toxicities and similar late complications.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [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. Radiotherapy / adverse effects. Treatment Outcome

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  • (PMID = 16188131.001).
  • [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] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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97. Chi KH, Chang YC, Guo WY, Leung MJ, Shiau CY, Chen SY, Wang LW, Lai YL, Hsu MM, Lian SL, Chang CH, Liu TW, Chin YH, Yen SH, Perng CH, Chen KY: A phase III study of adjuvant chemotherapy in advanced nasopharyngeal carcinoma patients. Int J Radiat Oncol Biol Phys; 2002 Apr 1;52(5):1238-44
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  • [Title] A phase III study of adjuvant chemotherapy in advanced nasopharyngeal carcinoma patients.
  • PURPOSE: To evaluate the role of adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma (NPC) patients, we conducted a randomized Phase III trial comparing radiotherapy (RT) followed by adjuvant chemotherapy to RT alone in patients with advanced NPC.
  • METHODS AND MATERIALS: Between November 1994 and March 1999, 157 patients with Stage IV, M(0) (UICC/AJCC, 1992) advanced NPC disease were randomized to receive standard radiotherapy, as follows: 35-40 fractions, 1.8-2.0 Gy/fraction/day, 5 days/week, to a total dose 70-72 Gy with or without 9 weekly cycles of 24-h infusional chemotherapy (20 mg/m(2) cisplatin, 2,200 mg/m(2) 5-fluorouracil, and 120 mg/m(2) leucovorin) after RT.
  • Of 157 patients enrolled, 154 (77 radiotherapy, 77 combined therapy) were evaluable for survival and toxicity analysis.
  • RESULTS: With a median follow-up of 49.5 months, the 5-year overall survival and relapse-free survival rates were 60.5% vs. 54.5% (p = 0.5) and 49.5% vs. 54.4% (p = 0.38) for the radiotherapy-alone group and the combined radiotherapy and adjuvant chemotherapy group, respectively.
  • The Cox regression showed that the hazard rates ratio of combined treatment to RT alone was 0.673 (p value = 0.232); the 95% confidence interval was 0.352 and 1.288, respectively.
  • Patients who received combined treatment had a lower systemic relapse rate than radiotherapy-alone patients, according to relapse pattern analysis.
  • The incidence of leukopenia (>or= Grade 3) occurred in 17 out of 819 (2.1%) cycles of weekly chemotherapy.
  • No patient developed moderate to severe mucositis (>or= Grade 3).
  • CONCLUSIONS: We conclude that adjuvant chemotherapy after RT for patients with advanced NPC has no benefit for overall survival or relapse-free survival.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cause of Death. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Confidence Intervals. Disease-Free Survival. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Leucovorin / administration & dosage. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Radiotherapy Dosage. Survival Analysis

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  • (PMID = 11955734.001).
  • [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 III; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; PFL protocol
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98. 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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99. Kim JG, Sohn SK, Kim DH, Baek JH, Jeon SB, Chae YS, Lee KB, Park JS, Sohn JH, Kim JC, Park IK: Phase II study of concurrent chemoradiotherapy with capecitabine and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck. Br J Cancer; 2005 Nov 14;93(10):1117-21
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  • [Title] Phase II study of concurrent chemoradiotherapy with capecitabine and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck.
  • We aimed to evaluate the efficacy and safety of concurrent chemoradiotherapy with capecitabine and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN).
  • In total, 37 patients with stage III or IV SCCHN were enrolled on the study.
  • The chemotherapy consisted of two cycles of intravenous cisplatin of 80 mg m(-2) on day 1 and oral capecitabine 825 mg m(-2) twice daily from day 1 to day 14 at 3-week intervals.
  • The radiotherapy (1.8-2.0 Gy 1 fraction day(-1) to a total dose of 70-70.2 Gy) was delivered to the primary tumour site and neck.
  • The primary tumour sites were as follows: oral cavity (n=6), oropharynx (n=11), hypopharynx (n=8), larynx (n=3), nasopharynx (n=6), and paranasal sinus (n=3).
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Cisplatin / therapeutic use. Deoxycytidine / analogs & derivatives. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Capecitabine. Disease Progression. Drug Therapy, Combination. Female. Fluorouracil / analogs & derivatives. Humans. Male. Middle Aged. Neoplasm Staging. Survival Rate

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  • (PMID = 16251869.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2361495
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100. 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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