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1. Guo L, Lin HX, Xu M, Chen QY, Wang CT, Huang PY: Phase I study of TPF neoadjuvant chemotherapy followed by radical radiotherapy in advanced nasopharyngeal carcinoma. Chin J Cancer; 2010 Feb;29(2):136-9
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  • [Title] Phase I study of TPF neoadjuvant chemotherapy followed by radical radiotherapy in advanced nasopharyngeal carcinoma.
  • BACKGROUND AND OBJECTIVE: PF regimen is the standard chemotherapy for advanced head and neck cancers including nasopharyngeal cancer.
  • The purpose of this study was to evaluate the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of TPF neoadjuvant regimen (taxotere, cisplatin (DDP) and 5-fluorouracil (5-FU)) followed by radical radiotherapy in advanced nasopharyngeal carcinoma (NPC).
  • METHODS: Between December 2006 and May 2008, 41 patients with newly diagnosed UICC stage III or IV advanced nasopharyngeal cancer were enrolled.
  • The treatment was repeated every 3 weeks for two cycles.
  • Radiotherapy was started from the 5th week, with 68-72 Gy/34-36 fractions delivered to the nasopharynx and 60-66 Gy/30-33 fractions to the node-positive area.
  • RESULTS: Forty patients (79 cycles) were evaluated for toxicity and efficacy of the therapy.
  • At dose level 5, three of six patients experienced DLT including grade III/IV neutropenia lasting more than 1 week.
  • Two of them also had grade III mucositis, leading to the interruption of radiotherapy for more than 1 week.
  • Three more new patients were retreated with the same dose (at dose level 6) under the G-CSF support, and no DLT occurred.
  • Dose escalation continued to level 7, and DLT was found in all of the four patients, including three grade IV neutropenia, one of them had fever and pneumonitis; three grade III diarrhea; and one grade III mucositis lasting 10 days.
  • Dose escalation was stopped and three more new patients were treated again at dose level 5 and no DLT was found.
  • Other severe toxicities included grade III anemia (1 patients), grade III vomiting (4 patients), and grade III weight loss (9 patients).
  • CONCLUSION: TPF neoadjuvant chemotherapy is a safe and effective regimen in the treatment of advanced NPC, with recommended doses of taxotere 60 mg/m(2) d1, DDP 60 mg/m(2) d1, and 5-FU 600 mg/m(2) d1-5.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Taxoids / administration & dosage
  • [MeSH-minor] Adult. Cisplatin / adverse effects. Cisplatin / therapeutic use. Female. Fluorouracil / adverse effects. Fluorouracil / therapeutic use. Humans. Male. Maximum Tolerated Dose. Middle Aged. Mucositis / chemically induced. Neoadjuvant Therapy. Neoplasm Staging. Neutropenia / chemically induced. Radiotherapy, High-Energy / adverse effects

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  • (PMID = 20109339.001).
  • [ISSN] 1000-467X
  • [Journal-full-title] Chinese journal of cancer
  • [ISO-abbreviation] Chin J Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; TPF protocol
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2. Ali H, al-Sarraf M: Chemotherapy in advanced nasopharyngeal cancer. Oncology (Williston Park); 2000 Aug;14(8):1223-30; discussion 1232-7, 1239-42

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  • [Title] Chemotherapy in advanced nasopharyngeal cancer.
  • Chemotherapy is an integral part of treatment for patients with nasopharyngeal carcinoma.
  • Chemotherapy can achieve long-term survival rates of up to 15% to 20%, even in patients with recurrent or metastatic disease.
  • In the majority of studies reported, patients with previously untreated locally advanced stage III and IV nasopharyngeal carcinoma showed improved local control, decreased systemic metastasis, and improved disease-free and overall survival when treated with cisplatin (Platinol)-based combination chemotherapy in conjunction with radiotherapy.
  • In prospective, randomized, phase III trials, concurrent chemoradiotherapy, followed by adjuvant chemotherapy, significantly improved local control, systemic control, and progression-free and overall survival.
  • The authors believe that different sequences of treatment modalities and newer chemotherapy agents need to be investigated in the future.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Clinical Trials as Topic. Combined Modality Therapy. Humans. Neoplasm Staging. Prognosis. Survival Analysis

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  • (PMID = 10989829.001).
  • [ISSN] 0890-9091
  • [Journal-full-title] Oncology (Williston Park, N.Y.)
  • [ISO-abbreviation] Oncology (Williston Park, N.Y.)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Number-of-references] 83
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3. 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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4. 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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5. 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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6. Kong L, Zhang YW, Hu CS, Guo Y: Neoadjuvant chemotherapy followed by concurrent chemoradiation for locally advanced nasopharyngeal carcinoma. Chin J Cancer; 2010 May;29(5):551-5
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  • [Title] Neoadjuvant chemotherapy followed by concurrent chemoradiation for locally advanced nasopharyngeal carcinoma.
  • BACKGROUND AND OBJECTIVE: Concurrent chemoradiation therapy (CCRT) is the standard treatment for patients with locally advanced nasopharyngeal carcinoma (NPC).
  • The effect of neoadjuvant chemotherapy followed by CCRT has not been determined.
  • Therefore, we conducted 2 phase II studies to evaluate the efficacy and safety of neoadjuvant chemotherapy with a regimen of docetaxel, cisplatin, and 5 fluorouracil (5-Fu) (TPF) followed by radiotherapy and concurrent cisplatin in patients with stage III and IV(A - B) NPC.
  • This article is the preliminary report on treatment related toxicities and response.
  • METHODS: Graded according to the 2002 American Joint Committee on Cancer (AJCC) staging criteria, only patients with stage III or IV(A-B) poorly differentiated or undifferentiated NPC (World Health Organization type II/III) were included.
  • We planned to recruit 52 patients with stage III disease and 64 patients with stage IV(A - B) disease.
  • All patients received neoadjuvant chemotherapy with TPF (docetaxel 75 mg/m(2), day 1; cisplatin 75 mg/m(2), day 1; 5 Fu 500 mg/(m2 x day), continuous intravenous infusion for 120 h), every 3 weeks for 3 cycles, followed by weekly cisplatin (40 mg/m(2)) concurrent with radiotherapy.
  • Gross disease planning target volume (PTV), high risk and low risk subclinical PTV doses were prescribed at 70-76 Gy, 66-70 Gy, and 60-61.25 Gy at 1.75-2.0 Gy per fraction.
  • The lower neck or supraclavicular fields may be treated with conventional AP/PA fields for a total of 54 Gy at 1.8 Gy per fraction.
  • Patients were evaluated for tumor response after the completion of neoadjuvant chemotherapy, and at 3 months after radiation according to the Response Evaluation Criteria In Solid Tumors (RECIST).
  • The latest version of the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE 3.0) was used for grading all adverse events.
  • RESULTS: Fifty nine patients were evaluable for treatment response.
  • Thirty patients had stage III disease and 29 patients had stage IV(A-B).
  • All patients completed RT to the prescribed dose and 2 cycles of neoadjuvant chemotherapy, with 51 patients (86.4%) completing 3 cycles.
  • The overall response rate in the primary site and the neck region were 94.9% [complete response (CR) in 25.4%] and 100% (CR in 19.6%) after completing neoadjuvant chemotherapy.
  • After a median follow up of 14.3 months, we observed 5 treatment failures and 2 deaths.
  • The rates of grade 3/4 myelosuppression and anorexia/nausea/vomiting during neoadjuvant chemotherapy were 55.9% and 16.9%, respectively.
  • There were no treatment related deaths.
  • CONCLUSIONS: Neoadjuvant chemotherapy with TPF followed by CCRT was well tolerated with a manageable toxicity profile.
  • [MeSH-major] Chemoradiotherapy. Chemotherapy, Adjuvant. Nasopharyngeal Neoplasms / therapy. Neoadjuvant Therapy
  • [MeSH-minor] Adult. Aged. Anemia / chemically induced. Anemia / etiology. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / adverse effects. Cisplatin / therapeutic use. Female. Fluorouracil / adverse effects. Fluorouracil / therapeutic use. Follow-Up Studies. Humans. Leukopenia / chemically induced. Leukopenia / etiology. Male. Middle Aged. Nausea / chemically induced. Nausea / etiology. Neoplasm Staging. Neutropenia / chemically induced. Neutropenia / etiology. Radiotherapy, Conformal. Radiotherapy, Intensity-Modulated. Remission Induction. Survival Rate. Taxoids / adverse effects. Taxoids / therapeutic use. Young Adult

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  • (PMID = 20426907.001).
  • [ISSN] 1000-467X
  • [Journal-full-title] Chinese journal of cancer
  • [ISO-abbreviation] Chin J Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Taxoids; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; TPF protocol
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7. Wu H, Lin Q, Yu ZH, Yang ZX, Feng LP: [Late course conformal radiotherapy combined with chemotherapy for stage III and IV a nasopharyngeal carcinoma]. Zhonghua Yi Xue Za Zhi; 2005 Jul 6;85(25):1778-80
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  • [Title] [Late course conformal radiotherapy combined with chemotherapy for stage III and IV a nasopharyngeal carcinoma].
  • OBJECTIVE: To evaluate the effect and acute toxicity of late course conformal radiotherapy combined with chemotherapy for stage III and IV a nasopharyngeal carcinoma (NPC).
  • METHODS: Ninety-six patients with stage III and IV a NPC were randomly divided into 2 groups: test group (n = 46, undergoing late course conformal radiotherapy combined with chemotherapy) and control group (n = 50, undergoing conventional radiotherapy).
  • Both groups were treated with one-period chemotherapy, including cisplantin, 5-fluouracil, and calcium folinate, before and after the radiotherapy.
  • The radiotherapy of the test group consisted of 2 phases: 36.0 approximately 40.0 Gy in 18 approximately 20 fractions over 3.5-4 weeks as the first phase using conventional technique was delivered with 2 lateral opposing faciocervical fields, and then 30.0-46.0 Gy in 15-23 fractions over 3-4.5 weeks as the second phase using three-dimensional conformal radiotherapy (3D-CRT).
  • The nasopharyngeal 1 year control rate of the test group was 97.83%, significantly higher than that of the control group (78.00%, P = 0.03).
  • CONCLUSION: Late course conformal radiotherapy combined with chemotherapy effectively improves the disease control, delays the distant metastasis, and alleviates radioactivity damnification.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Conformal
  • [MeSH-minor] Adolescent. Adult. Aged. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / administration & dosage. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Male. Middle Aged

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  • (PMID = 16253169.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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8. Chan SC, Yen TC, Ng SH, Lin CY, Wang HM, Liao CT, Fan KH, Chang JT: Differential roles of 18F-FDG PET in patients with locoregional advanced nasopharyngeal carcinoma after primary curative therapy: response evaluation and impact on management. J Nucl Med; 2006 Sep;47(9):1447-54
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  • [Title] Differential roles of 18F-FDG PET in patients with locoregional advanced nasopharyngeal carcinoma after primary curative therapy: response evaluation and impact on management.
  • This prospective study compares the efficacies of whole-body (18)F-FDG PET and a conventional work-up (CWU) in evaluating the treatment response for patients with locoregional advanced nasopharyngeal carcinoma (NPC) after primary curative therapy and investigates the impact of PET on patient management.
  • METHODS: Patients who had locoregional advanced NPC (stages III and IVa-b, staged by (18)F-FDG PET and CWU) and who had completed primary curative therapy for 3 mo were enrolled.
  • The curative therapy consisted of concurrent chemoradiotherapy with or without induction chemotherapy.
  • The criteria for final diagnosis were based on pathology or subsequent follow-up for at least 6 mo.
  • Rates of detection by (18)F-FDG PET and CWU and the impact on management were determined on site and patient bases, respectively.
  • RESULTS: From January 2002 to August 2005, 131 patients with NPC were eligible, including 71 patients with stage III NPC (group A) and 60 patients with stage IVa-b NPC (group B).
  • CONCLUSION: (18)F-FDG PET plays differential roles in patients with stage III NPC and stage IVa-b NPC after primary curative therapy.
  • PET has higher sensitivity and specificity in evaluating the response and results in better management of patients with stage IVa-b NPC.
  • PET has a less prominent impact on patient management but higher sensitivity in patients with stage III NPC.
  • [MeSH-major] Fluorodeoxyglucose F18. Nasopharyngeal Neoplasms / radionuclide imaging. Nasopharyngeal Neoplasms / therapy. Neoplasm Recurrence, Local / prevention & control. Neoplasm Recurrence, Local / radionuclide imaging. Outcome Assessment (Health Care) / methods. Positron-Emission Tomography / methods

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  • (PMID = 16954552.001).
  • [ISSN] 0161-5505
  • [Journal-full-title] Journal of nuclear medicine : official publication, Society of Nuclear Medicine
  • [ISO-abbreviation] J. Nucl. Med.
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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9. 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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10. Cheng SH, Jian JJ, Tsai SY, Yen KL, Chu NM, Chan KY, Tan TD, Cheng JC, Leu SY, Hsieh CY, Huang AT: Long-term survival of nasopharyngeal carcinoma following concomitant radiotherapy and chemotherapy. Int J Radiat Oncol Biol Phys; 2000 Dec 1;48(5):1323-30
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  • [Title] Long-term survival of nasopharyngeal carcinoma following concomitant radiotherapy and chemotherapy.
  • PURPOSE: The purpose of this study is to demonstrate long-term survival of nasopharyngeal carcinoma treated with concomitant chemotherapy and radiotherapy (CCRT) followed by adjuvant chemotherapy.
  • METHODS AND PATIENTS: One hundred and seven patients with Stage III and IV (American Joint Committee on Cancer, AJCC, 1988) nasopharyngeal carcinoma (NPC) were treated with concomitant chemotherapy and radiotherapy (CCRT) followed by adjuvant chemotherapy between April 1990 and December 1997 in Koo Foundation Sun Yat-Sen Cancer Center, Taipei.
  • The dose of radiation was 70 Gray (Gy) given in 35 fractions, 5 fractions per week.
  • Two courses of chemotherapy, consisting of cisplatin and 5-fluorouracil, were delivered simultaneously with radiotherapy in Weeks 1 and 6 and two additional monthly courses were given after radiotherapy.
  • According to the AJCC 1997 staging system, 32 patients had Stage II disease, 44 had Stage III, and 31 had Stage IV disease.
  • The 3-year overall survival for Stage II was 100%, for Stage III it was 92.8%, and for Stage IV, 69.
  • The 3-year disease-free survival for Stage II was 96.9%, for Stage III it was 87.7%, and for Stage IV it was 51.9% (p = 0.0001).
  • CONCLUSION: CCRT and adjuvant chemotherapy is effective in Taiwanese patients with advanced NPC.
  • The prognosis of AJCC 1997 Stage II and III disease is excellent, but, for Stage IV (M0), it is relatively poor.
  • Future strategies of therapy should focus on high-risk AJCC 1997 Stage IV (M0) cohort.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Radiation-Sensitizing Agents / therapeutic use
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Patient Compliance. Radiotherapy Dosage. Survival Rate. Taiwan. Treatment Failure

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2000 Dec 1;48(5):1277-9 [11121623.001]
  • (PMID = 11121629.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Radiation-Sensitizing Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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11. Al-Sarraf M, Reddy MS: Nasopharyngeal carcinoma. Curr Treat Options Oncol; 2002 Feb;3(1):21-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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12. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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13. 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

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

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  • (PMID = 16200771.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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15. Adane S, Sadouki M, Mekki F, Bouzid K: Gemcitabine (G) plus cisplatin (C) plus radiotherapy in first-line treatment of locally advanced and metastatic undifferentiated carcinoma of the nasopharyngeal type (UCNT): Preliminary results of a phase II study. J Clin Oncol; 2004 Jul 15;22(14_suppl):5618

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gemcitabine (G) plus cisplatin (C) plus radiotherapy in first-line treatment of locally advanced and metastatic undifferentiated carcinoma of the nasopharyngeal type (UCNT): Preliminary results of a phase II study.
  • : 5618 Background: In our experience, G is efficient (44%) in third-line monotherapy of recurrent metastatic nasopharynx carcinoma after first-line 5-fluorouracil + C and second-line anthracyclines + taxanes (ASCO 2002 abstract #3034).
  • In this prospective, phase II study, we used G + C in neoadjuvant setting before radiotherapy in first-line treatment of patients (pts) with locally advanced and metastatic UCNT.
  • METHODS: Chemonaive pts with histologically (WHO type 3) proven stage III and IV TNM/UICC 1997, and an ECOG performance status (PS) 0-2 received G 1250 mg/m<sup>2</sup> over a 30-minute infusion on days (D) 1 and 8 and C 70 mg/m<sup>2</sup> on D1, every 3 weeks.
  • Four to 6 weeks after the third cycle of induction chemotherapy, curative intent radiotherapy was given on nasopharynx (70-72 Gys) and on cervical nodes (50 Gys).
  • Follow-up was performed 4 weeks after the third cycle by clinical evaluation, CT scan of nasopharynx, and nasofibroscopy with biopsy.
  • Seven pts had stage IVA, 3 pts had stage IVC, and 2 pts had stage III.
  • A total of 43 cycles have been completed with a median of 3.6 cycles (range 2-4).

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  • (PMID = 28015275.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Bossi P, Parolini D, Bergamini C, Locati LD, Orlandi E, Franceschini M, Palazzi M, Olmi P, Potepan P, Licitra L: TPF induction chemotherapy (CT) followed by concomitant cisplatin/radiotherapy (cCTRT) in locally advanced nasopharyngeal cancer (LANPC). J Clin Oncol; 2009 May 20;27(15_suppl):6046

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

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  • (PMID = 27961922.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Beldjilali Y, Benhadji KA, Boukerche A, Khellafi H, Abdelaoui A, Betkaoui F, Tourabi ZK, Kaïd MY, Djellali L, Yamouni M: First results of induction chemotherapy with cisplatin, docetaxel, and capecitabine for the treatment of nasopharyngeal carcinoma. J Clin Oncol; 2009 May 20;27(15_suppl):6045

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

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  • (PMID = 27961921.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Chan AT, Ngan R, Teo P, Leung SF, Yiu HY, Yeo W, Mok T, Cheung FY, Kwan W, Zee B: Final results of a phase III randomized study of concurrent weekly cisplatin-RT versus RT alone in locoregionally advanced nasopharyngeal carcinoma (NPC). J Clin Oncol; 2004 Jul 15;22(14_suppl):5523

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Final results of a phase III randomized study of concurrent weekly cisplatin-RT versus RT alone in locoregionally advanced nasopharyngeal carcinoma (NPC).
  • : 5523 Background/Objective: NPC is highly radiosensitive and chemosensitive.
  • 3 cycles of 3-weekly chemotherapy concurrent with RT followed by 3 cycles of adjuvant chemotherapy has improved survival over RT alone in a previous randomized study.
  • This randomized phase III study compared concurrent weekly cisplatin-RT with RT alone in patients with locoregionally advanced NPC.
  • METHODS: Patients with Ho's N2 or N3 stage or N1 stage with nodal size ≥ 4 cm were randomized to receive cisplatin 40 mg/m<sup>2</sup> weekly up to 8 weeks concurrently with RT (CRT) or RT alone.
  • Baseline patient characteristics, treatment toxicities and PFS analysis at median follow up of 2.71 years have been published previously.
  • Using Cox regression analysis, male sex (p=0.0284), advanced Ho's T (p=0.0002) and advanced age (p=0.0019) had poorer prognoses.
  • The treatment-by-covariate interaction effect was not significant under the Cox model (p=0.1122, 3 d.f.).
  • The treatment effect on OS remains borderline significant in favor of CRT (p=0.0586, with hazards ratio of 1.40 with 95% C.I.
  • There were no treatment-related deaths.
  • CONCLUSION: Weekly cisplatin-RT is well tolerated in patients with advanced NPC in endemic areas and is associated with clinically significant improvement in PFS and OS.
  • This regime can be offered as standard treatment in locoregionally advanced NPC.

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  • (PMID = 28013951.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Sze WM, Lee AW, Tong M, Ng C, Soong I, Chan K, Yeung R, Yau TK: Preliminary experience on treating advanced nasopharyngeal carcinoma (NPC) affecting/abutting neurological structures with induction chemotherapy followed by concurrent chemo-radiation with accelerated fractionation. J Clin Oncol; 2004 Jul 15;22(14_suppl):5525

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preliminary experience on treating advanced nasopharyngeal carcinoma (NPC) affecting/abutting neurological structures with induction chemotherapy followed by concurrent chemo-radiation with accelerated fractionation.
  • : 5525 Background: To study the possibility of improving treatment tolerance and outcome for NPC with extensive infiltration affecting/ abutting neurological structures by induction chemotherapy followed by concurrent chemo-radiation with accelerated fractionation.
  • METHODS: During April 2001 to Feb 2003, 33 NPC patients with such ominous infiltration were treated with this strategy.
  • Ninty-four percent of patients had UICC (5<sup>th</sup> edition) Stage IVA-B and 6% had Stage III disease.
  • Thirty-two patients (97%) had undifferentiated carcinoma and only 1 patient had well differentiated squamous cell carcinoma.
  • The chemotherapy plan included 3 cycles of Cisplatin (80 mg/m<sup>2</sup> ) and Gemcitabine (1250 mg/m<sup>2</sup> D1,8) for induction phase, and 2 cycles of Cisplatin (100 mg/m<sup>2</sup> D1) for the concurrent phase.
  • All patients were irradiated to a total dose of 70 Gy using 3-D conformal techniques and accelerated fractionation at 2 Gy per fraction, 6 daily fractions per week, throughout the whole course.
  • RESULTS: All patients completed the intended radiotherapy dose and the median overall treatment time was 41 days (range: 39-53).
  • The mean weight loss during the whole course of treatment was 11% of the initial body weight.
  • The chemotherapy toxicities and compliance are shown in table 1.
  • CONCLUSIONS: The early treatment results achieved for this very poor prognostic group was very encouraging, but late toxicity has yet to be fully assessed and confirmation of therapeutic gain by prospective randomized trial is warranted.

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  • (PMID = 28013949.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Majem M, Martinez M, Galiana R, Montes A, Cardenal F, Rodon J, Nogues J, Perez FJ, Gomez J, Mesia R: Analysis of 46 patients with nasopharyngeal carcinoma treated with hyperfractionated radiotherapy in a single institution. J Clin Oncol; 2004 Jul 15;22(14_suppl):5616

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Analysis of 46 patients with nasopharyngeal carcinoma treated with hyperfractionated radiotherapy in a single institution.
  • : 5616 Background: New fractionations in radiotherapy (RT) on head and neck cancer have emerged to increase local control.
  • Addition of chemotherapy (CT) in advanced nasopharyngeal tumors tries to decrease local and distant recurrence.
  • We report our results in non-Asiatic patients (pts) with advanced nasophayngeal carcinoma treated with induction CT and hyperfractionated RT (hfRT).
  • METHODS: Forty-six pts with nasopharyngeal carcinoma have been treated from 10/94 to 05/02: 79% male and 21% female, median age: 51 years (18-76).
  • Hystologic subtypes: 33% keratonizing squamous cell carcinoma (KSCC), 8% nonKSCC, 59% undifferentiated carcinoma.
  • Stage (2002 UICC Classification): 4 IIa, 11 IIb, 14 III, 10 IVa and 7 IVb.
  • The median HfRT dose was 80.4 Gy administered at 1.2 Gy/ fraction twice day.
  • Two of these pts (1 local, 1 nodal) are free of disease with salvage therapy.
  • CONCLUSIONS: hfRT might be an effective treatment for nasopharyngeal carcinoma.

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  • (PMID = 28015277.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Chua DT, Ma J, Sham JS: 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; 2004 Jul 15;22(14_suppl):5524

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term survival after cisplatin-based induction chemotherapy and radiotherapy for nasopharyngeal carcinoma: A pooled data analysis of two phase III trials.
  • : 5524 Background: To evaluate the long-term treatment outcome in patients with advanced stage nasopharyngeal carcinoma (NPC) treated by cisplatin-based induction chemotherapy and radiotherapy (CRT) versus radiotherapy alone (RT).
  • METHODS: The updated records of two previously reported phase III studies (the Asian-Oceania Clinical Oncology Association trial and the Guangzhou trial).
  • testing the benefit of adding induction chemotherapy to radiotherapy in NPC were reviewed and the data were pooled together for analysis.
  • The induction chemotherapy consisting of 2-3 cycles of cisplatin 100 mg/m<sup>2</sup> day 1, bleomycin 10 mg/m<sup>2</sup> day 1 & 5, and fluorouracil 800 mg/m<sup>2</sup> day 1-5, or cisplatin 60 mg/m<sup>2</sup> day 1 and epirubicin 110 mg/m<sup>2</sup> day 1.
  • Radiotherapy was given to the nasopharynx and neck using megavoltage radiation, with a median dose of 70 Gy.
  • Treatment compliance was 92.6% in the CRT arm and 98% in the RT arm.
  • The median follow-up time for surviving patients was 67 months.
  • RESULTS: The addition of induction chemotherapy to radiotherapy was associated with a decrease in relapse by 14.3% and cancer deaths by 12.9% at 5 years.
  • The incidence of loco-regional failure and distant metastases were reduced by 18.3% and 13.3% at 5 years respectively with induction chemotherapy.
  • CONCLUSIONS: The addition of cisplatin-based induction chemotherapy to radiotherapy was associated with a modest but significant improvement in survival in advanced stage NPC.

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  • (PMID = 28013950.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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22. Yee D, Lau H, Siever J, Brasher P, Mackinnon J, Gluck S: Concurrent chemoradiotherapy (chemoRT) for nasopharyngeal carcinoma (NPC): 10-year experience at a single institute. J Clin Oncol; 2004 Jul 15;22(14_suppl):5573

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Concurrent chemoradiotherapy (chemoRT) for nasopharyngeal carcinoma (NPC): 10-year experience at a single institute.
  • : 5573 Background: Radical treatment of NPC consists of radiotherapy (RT) ± chemotherapy.
  • The ideal chemotherapy regimen to be given with RT is unknown.
  • We report our institute's experience with radical treatment of NPC.
  • METHODS: Seventy-nine NPC patients were treated radically at the Tom Baker Cancer Centre (TBCC) between 1992-2002.
  • Their charts were reviewed for initial patient characteristics, treatment given, rate of grade 3-4 acute and late toxicities according to the Radiation Therapy Oncology Group (RTOG) scales, failure patterns and causes of death.
  • Kaplan Meier estimates of 3-year overall and disease-free survival (OS, DFS) were calculated.
  • RESULTS: The majority of patients (63.3%) had stage III-IVb disease.
  • Mean RT dose to gross disease was 67.9 Gy and mean treatment time was 50.7 days.
  • 94.4%, 80.0%, and 81.2% of each group received all prescribed treatments, respectively.
  • With a mean follow-up of 65 months, the 3-year estimate of DFS in each group was 54.4%, 64.4%, and 73.3%, respectively.
  • With a mean follow-up of 88 months, the 3-year estimate of OS in each group was 49.9%, 67.9% and 70.2%, respectively.
  • There were no treatment-related deaths.
  • 25.3% of patients were hospitalized during treatment and 71.6% lost =< 9.9% of their pre-treatment weight.
  • The majority of deaths were NPC-related (90.3%).
  • CONCLUSIONS: At the TBCC, concurrent chemoRT for NPC confers a trend for improved DFS and OS compared with RT alone.
  • Toxicity rates in NPC patients receiving concurrent chemoRT were acceptable.

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  • (PMID = 28014004.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Choi JH, Lim HY, Park JS, Kim HC, Kang S, Oh YT, Chun M, Kim CH: Induction chemotherapy (CTX) followed by concurrent chemoradiotherapy (CRT) in patients (pts) with nasopharyngeal cancer (NPC). J Clin Oncol; 2004 Jul 15;22(14_suppl):5598

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

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  • (PMID = 28014052.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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24. Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, Chua ET, Lee KM, Yang E, Machin D: Phase III randomized trial of radiotherapy versus concurrent chemo-radiotherapy followed by adjuvant chemotherapy in patients with AJCC/UICC (1997) stage 3 and 4 nasopharyngeal cancer of the endemic variety. J Clin Oncol; 2004 Jul 15;22(14_suppl):5500

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

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  • (PMID = 28014208.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Kerboua E: Capecitabine and cisplatyl as neoadjuvant treatment of locally advanced nasopharyngeal carcinoma. J Clin Oncol; 2009 May 20;27(15_suppl):e17036

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Capecitabine and cisplatyl as neoadjuvant treatment of locally advanced nasopharyngeal carcinoma.
  • : e17036 Background: The main objective of this study is to evaluate the activity and safety of capecitabine (X) and cisplatyl (C) in patients (pts) with locally advanced nasopharyngeal carcinoma(NPC).
  • Capecitabine was reported to have single-agent activity in advanced/metastatic NPC.
  • METHODS: Pts with undifferentiated NPC type were enrolled from July 2007 to September 2008.
  • RESULTS: Forty-one (41) pts have been enrolled 28 male/13 female with locally advanced NPC: 15 pts (36,6% ) were stage III (UICC 1997) 26 pts (63,3%) stage IV (n = 6 IVA and n = 20 IVB).
  • Two pts died from sepsis that was probably treatment-related.
  • CONCLUSIONS: Preliminary results show that X plus C provide an active regimen with an acceptable tolerability profile as neoadjuvant chemotherapy for locally advanced NPC.

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  • (PMID = 27961801.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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26. Djedi H, Bouzid K: Capecitabine-based chemotherapy versus primary treatment for patients with advanced stages of undifferentiated nasopharyngeal carcinoma (UCNT): Preliminary results of a phase II study. J Clin Oncol; 2009 May 20;27(15_suppl):e17049

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

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  • (PMID = 27961741.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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27. Vermorken JB, Remenar E, van Herpen C, Germa Lluch J, Stewart S, Gorlia T, Degardin M, Schollen K, Bernier J: Standard cisplatin/infusional 5-fluorouracil (PF) vs docetaxel (T) plus PF (TPF) as neoadjuvant chemotherapy for nonresectable locally advanced squamous cell carcinoma of the head andneck (LA-SCCHN): a phase III trial of the EORTC Head and Neck Cancer Group (EORTC #24971). J Clin Oncol; 2004 Jul 15;22(14_suppl):5508

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Standard cisplatin/infusional 5-fluorouracil (PF) vs docetaxel (T) plus PF (TPF) as neoadjuvant chemotherapy for nonresectable locally advanced squamous cell carcinoma of the head andneck (LA-SCCHN): a phase III trial of the EORTC Head and Neck Cancer Group (EORTC #24971).
  • Ann Oncol 15: 638, 2004), we undertook a phase III trial comparing TPF with PF in such patients (pts).
  • METHODS: Eligible pts included nonresectable LA-SCCHN (excluding nasopharynx, nasal & paranasal cavities), measurable disease, adequate organ function, WHO performance status (PS) 0-1, age 18-70 yrs, signed informed consent.
  • Treatment arms were: Arm 1 (PF): P 100 mg/m<sup>2</sup> day (d) 1, then F 1000 mg/m<sup>2</sup> CI d1-5 q 21 d; Arm 2 (TPF): T 75 mg/m<sup>2</sup> d1, P 75 mg/m<sup>2</sup> d1, then 5-FU 750 mg/m<sup>2</sup> CI d1-5 q 21 d.
  • Planned treatment included 4 cycles unless progression (PD), unacceptable toxicity or pt refusal.
  • Pt/tumor characteristics (age, sex, PS, primary site, T&N stage) were well balanced.

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  • (PMID = 28014200.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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28. Karasawa K, Umezawa T, Hanyu N, Kawamura H, Kiguchi Y, Mitsuhashi T, Niibe Y: Hyperfractionated radiation therapy for the treatment of squamous cell carcinoma of the head and neck. J Clin Oncol; 2004 Jul 15;22(14_suppl):5554

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

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  • (PMID = 28013972.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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29. Fuwa N, Kodaira T, Furutani K, Tatibana H, Toita T, Shikama N, Kano M, Hayasi N, Yuta A: Alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil - A preliminary report of phase II study. J Clin Oncol; 2004 Jul 15;22(14_suppl):5613

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

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  • (PMID = 28015269.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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30. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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31. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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32. 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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33. 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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34. 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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35. 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


36. 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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37. Kang MY, Holland JM, Stevens KR Jr: Cranial neuropathy following curative chemotherapy and radiotherapy for carcinoma of the nasopharynx. J Laryngol Otol; 2000 Apr;114(4):308-10
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  • [Title] Cranial neuropathy following curative chemotherapy and radiotherapy for carcinoma of the nasopharynx.
  • Cranial neuropathy following concurrent chemotherapy and radiotherapy is unreported.
  • The authors report a case of a 54-year-old man treated with curative chemotherapy and radiotherapy for a stage III nasopharyngeal carcinoma who developed an unilateral hypoglossal nerve palsy five years after therapy.
  • Hypoglossal nerve injury occurring after head and neck radiotherapy is an indirect effect due to progressive soft tissue fibrosis and loss of vascularity.
  • Cranial nerve palsies, including damage to the hypoglossal nerve, can develop years after therapy with no evidence of tumour recurrence.
  • Chemotherapy and radiotherapy have improved progression-free and overall survival in advanced nasopharyngeal cancer.
  • As more patients achieve long-term tumour control following chemotherapy and radiotherapy, we must be cognizant of potential late injury to cranial nerves.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Hypoglossal Nerve Diseases / etiology. Nasopharyngeal Neoplasms / therapy. Radiation Injuries / etiology. Radiotherapy, High-Energy / adverse effects
  • [MeSH-minor] Combined Modality Therapy. Follow-Up Studies. Humans. Male. Middle Aged

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  • (PMID = 10845053.001).
  • [ISSN] 0022-2151
  • [Journal-full-title] The Journal of laryngology and otology
  • [ISO-abbreviation] J Laryngol Otol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] ENGLAND
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38. Kong L, Lu JJ, Hu C, Guo X, Wu Y, Zhang Y: The risk of second primary tumors in patients with nasopharyngeal carcinoma after definitive radiotherapy. Cancer; 2006 Sep 15;107(6):1287-93
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  • [Title] The risk of second primary tumors in patients with nasopharyngeal carcinoma after definitive radiotherapy.
  • BACKGROUND: Second primary tumors (SPTs) have a substantial impact on survival in cancer patients.
  • However, risk factors for SPTs have not been documented well, especially in nasopharyngeal carcinoma (NPC).
  • The objective of this retrospective analysis was to evaluate such risks in patients with NPC after they received definitive radiation treatment.
  • METHODS: Three hundred twenty-six consecutive patients with pathologically confirmed, nonmetastatic, undifferentiated NPC who received treatment between January 1, 1994 and December 30, 1995 were analyzed.
  • All patients were restaged in accordance with the 2002 American Joint Committee on Cancer staging classification.
  • There were 18 patients (5.5%) with Stage I NPC, 152 patients (46.6%) with Stage II NPC, 101 patients (31.0%) with Stage III NPC, and 55 patients (16.9%) with Stage IVA or IVB NPC at initial diagnosis.
  • All patients received definitive radiotherapy with either Cobalt-60 or megavoltage therapy.
  • High-dose-rate brachytherapy was given to 23 patients either as part of their primary treatment or as adjuvant treatment for residual lesions.
  • Seventeen patients (5.2%) developed SPTs, for an average annual rate of 1.0%, and the 5-year cumulative incidence was 5.8%.
  • Multivariate analysis showed that age was the only independent risk factor for developing SPTs after RT for NPC.
  • Other factors, including gender, tumor or lymph node classification, chemotherapy, total radiation dose to the nasopharynx, reirradiation, and adjuvant brachytherapy did not influence the risk of SPTs.
  • CONCLUSIONS: SPTs in patients with NPC occurred preferentially in the UADT and tended to develop within the irradiated field >5 years after patients received radiation.
  • Older patients with NPC (age >or=50 years) may be at increased risk.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Neoplasms, Second Primary / etiology. Radiotherapy / adverse effects
  • [MeSH-minor] Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Retrospective Studies. Risk Factors. Time Factors

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  • [Copyright] (c) 2006 American Cancer Society.
  • (PMID = 16909425.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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39. Jacobs JJ, Hordijk GJ, Jürgenliemk-Schulz IM, Terhaard CH, Koten JW, Battermann JJ, Den Otter W: Treatment of stage III-IV nasopharyngeal carcinomas by external beam irradiation and local low doses of IL-2. Cancer Immunol Immunother; 2005 Aug;54(8):792-8
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  • [Title] Treatment of stage III-IV nasopharyngeal carcinomas by external beam irradiation and local low doses of IL-2.
  • The therapeutic effect of intratumoural application of Interleukin-2 (IL-2) was studied in patients with stage III-IV nasopharyngeal carcinoma (NPC) that received radiotherapy.
  • Patients with stage III-IV NPC receiving a standard treatment of 7,000 cGy external beam irradiation have a mean disease-free survival of about 1.5 years.
  • In this paper, we describe ten of these patients who were treated with additional peritumoural and intratumoural injections with 3 x 10(4) U IL-2 on 5 days in weeks 2, 4, and 6 of the 7-weeks' irradiation period.
  • This combined treatment group was compared with a historical group of patients treated with standard irradiation alone.
  • Local IL-2 therapy showed a marked clinical and statistical significant improvement of disease-free survival.
  • These results suggest that the therapeutic results of radiotherapy can be significantly improved by combining it with local IL-2 treatment.
  • To our knowledge, this is the first clinical report showing that local IL-2 therapy is effective against an infiltrative and locally metastasizing tumour in human patients.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Interleukin-2 / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Metastasis. Treatment Outcome

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  • (PMID = 15627211.001).
  • [ISSN] 0340-7004
  • [Journal-full-title] Cancer immunology, immunotherapy : CII
  • [ISO-abbreviation] Cancer Immunol. Immunother.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Interleukin-2
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40. 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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41. Chua DT, Sham JS, Au GK, Choy D: Concomitant chemoirradiation for stage III-IV nasopharyngeal carcinoma in Chinese patients: results of a matched cohort analysis. Int J Radiat Oncol Biol Phys; 2002 Jun 1;53(2):334-43
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  • [Title] Concomitant chemoirradiation for stage III-IV nasopharyngeal carcinoma in Chinese patients: results of a matched cohort analysis.
  • PURPOSE: To evaluate the toxicity and efficacy of concomitant chemoirradiation (CRT) followed by adjuvant chemotherapy compared with radiotherapy (RT) alone in Chinese patients with locoregionally advanced nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: Between March 1997 and September 2000, 47 Chinese patients with Stage III (n = 9, 19%) and IV (n = 38, 81%) NPC were treated with by CRT using cisplatin 100 mg/m(2) on Days 1, 22, and 43 of RT, plus adjuvant chemotherapy using cisplatin 80 mg/m(2) for 1 day and 5-fluorouracil 1 g/m(2) for 4 days on Days 71, 99, and 127.
  • These patients were then compared with a cohort of 47 patients treated between 1990 and 1993 with RT alone, who were matched with respect to T stage, N stage, nodal bilaterality, nodal level, and nodal size.
  • The median biologic equivalent dose to 2 Gy per fraction delivered to the nasopharynx was 68 Gy in the CRT group and 65.3 Gy in the RT-alone group.
  • RESULTS: The compliance rates were 62% for concomitant chemotherapy and 40% for adjuvant chemotherapy.
  • No treatment-related deaths occurred.
  • At the end of treatment, 96% of the CRT group and 79% of the RT-alone group achieved a complete response (p = 0.013).
  • With a median follow-up of 26 months, the 3-year relapse-free survival, disease-specific survival, overall survival, local relapse-free survival, nodal relapse-free survival, and distant metastasis-free survival rate for the CRT group and the RT-alone group was 62% vs. 44% (p = 0.048), 67% vs. 71% (p = 0.88), 65% vs. 69% (p = 0.93), 87% vs. 75% (p = 0.059), 95% vs. 80% (p = 0.026), and 75% vs. 70% (p = 0.84), respectively.
  • CONCLUSION: Our experience indicates that concomitant CRT improves locoregional control in Chinese patients with locoregionally advanced NPC, but our analyses failed to detect any impact on distant failure and survival.
  • The failure to reduce distant metastasis and improve survival may have related in part to the more advanced disease stage in our patients and the relatively low compliance rate of adjuvant chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Case-Control Studies. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Cohort Studies. Disease-Free Survival. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Follow-Up Studies. Humans. Male. Middle Aged. Neck Dissection. Neoplasm Metastasis. Neoplasm Recurrence, Local. Neoplasm Staging. Patient Compliance. Radiotherapy Dosage. Salvage Therapy

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  • (PMID = 12023137.001).
  • [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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42. 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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43. 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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44. 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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45. Levendag PC, Lagerwaard FJ, Noever I, dePan C, vanNimwegen A, Wijers O, Schmitz PI, van Dieren E, Nowak PJ: Role of endocavitary brachytherapy with or without chemotherapy in cancer of the nasopharynx. Int J Radiat Oncol Biol Phys; 2002 Mar 1;52(3):755-68
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  • [Title] Role of endocavitary brachytherapy with or without chemotherapy in cancer of the nasopharynx.
  • PURPOSE: We previously reported our preliminary experience with nasopharyngeal cancer boosted after 60-70 Gy external beam radiotherapy (EBRT) by fractionated endocavitary brachytherapy (ECBT) to cumulative doses of 78-82 Gy.
  • As for Stage III-IVB disease, cisplatin (CDDP)-based neoadjuvant chemotherapy (CHT) was given.
  • METHODS AND MATERIALS: Ninety-one patients with primary nasopharyngeal cancer, staged according to the 1997 UICC/AJCC classification system, were treated between 1991 and 2000 with 60-70 Gy external beam radiotherapy and 11-18 Gy ECBT.
  • Treatment results were analyzed for local control (LC), disease-free survival (DFS), freedom from distant metastasis, and overall survival (OS).
  • RESULTS: A univariate and multivariate Cox regression analysis found stage, treatment period, age, and grade significant for LC, DFS, and OS.
  • At 2 years, for Stage I-IIB (1st period, 1991-1996), the LC, DFS, and OS were 96%, 88%, and 80%, respectively, vs. 65%, 46%, and 52% for Stage III-IVB.
  • For the 2nd treatment period (1996-2000; CHT for Stage III-IVB), the LC, DFS, and OS at 2 years was 100%, 90%, and 61% (Stage I-IIB), respectively, vs. 86%, 74%, and 66% (Stage III-IVB).
  • For the 1991-1996 period, at 2 years, patients in the good PG (UD Stage I-IIB disease) had 100% LC and 92% OS; those in the intermediate PG (UD Stage III-IVB or WMP-D Stage I-IIB), had 94% LC and 71% OS; and those in the poor PG (WMP-D Stage III-IVB) had 47% LC and 40% OS.
  • CONCLUSION: For Stage I-IIB disease treated between 1991 and 2000, at 3 years, the LC and OS was 97% and 67%, respectively.
  • The results with 77-81 Gy without CHT warrant EBRT combined with ECBT to remain our standard of care for Stage I-IIB disease.
  • Because of better target coverage and sparing, T3-4 tumors are currently boosted by stereotactic RT to 81.2 Gy.
  • [MeSH-major] Brachytherapy / methods. Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Conformal / methods
  • [MeSH-minor] Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Dose Fractionation. Female. Fluorouracil / administration & dosage. Humans. Male. Neoplasm Staging. Proportional Hazards Models. Survival Analysis. Treatment Outcome

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  • (PMID = 11849799.001).
  • [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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46. 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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47. 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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48. 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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49. Mizowaki T, Okajima K, Nagata Y, Mitsumori M, Nishimura Y, Shoji K, Asato R, Hiraoka M: Concurrent chemotherapy and radiotherapy with low-dose Cisplatin for nasopharyngeal carcinoma. Am J Clin Oncol; 2003 Apr;26(2):155-8
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  • [Title] Concurrent chemotherapy and radiotherapy with low-dose Cisplatin for nasopharyngeal carcinoma.
  • Eighty-one patients with nondisseminated nasopharyngeal carcinoma consecutively treated between January 1977 and December 1998 were analyzed to evaluate whether a concurrent adjunction of low-dose cisplatin enhances the outcome of definitive radiotherapy.
  • Ninety-eight percent (n = 79) of the cases were ranked as stage III/IV according to the 1987 Union International Contre le Cancer staging criteria.
  • However, multivariate analysis identified only the total dose and the T-stage as significant independent factors for locoregional control.
  • The results of the present study suggest that concurrent adjunction of low-dose cisplatin will not improve the outcome of definitive radiotherapy for nasopharyngeal carcinoma.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cisplatin / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy. Radiation-Sensitizing Agents / therapeutic use
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Proportional Hazards Models. Radiotherapy Dosage. Retrospective Studies. Survival Analysis. Treatment Failure

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  • (PMID = 12714887.001).
  • [ISSN] 0277-3732
  • [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] 0 / Antineoplastic Agents; 0 / Radiation-Sensitizing Agents; Q20Q21Q62J / Cisplatin
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50. 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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51. 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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52. 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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53. 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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54. 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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55. 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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56. 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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57. Chang YC, Chen SY, Lui LT, Wang TG, Wang TC, Hsiao TY, Li YW, Lien IN: Dysphagia in patients with nasopharyngeal cancer after radiation therapy: a videofluoroscopic swallowing study. Dysphagia; 2003;18(2):135-43
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  • [Title] Dysphagia in patients with nasopharyngeal cancer after radiation therapy: a videofluoroscopic swallowing study.
  • This study evaluated swallowing status and the factors influencing swallowing in patients with nasopharyngeal carcinoma (NPC) after radiation therapy.
  • During the period from July 1995 to June 1999, this cross-sectional study used videofluoroscopic swallowing study (VFSS) to evaluate 184 NPC patients who had completed radiation therapy [113 cases had completed radiation therapy < or = 12 months prior to evaluation (acute group) and 71 cases had completed radiation therapy > 12 months prior to evaluation (chronic group)].
  • The numbers of patients with tumors in each of the four stages were as follows: 24 in stage I, 45 in stage II, 41 in stage III, and 74 in stage IV.
  • Swallowing abnormalities of the acute and chronic groups were correlated with multiple variables, including gender, age, the stage of the tumor, use of either neoadjuvant chemotherapy or radiosensitizer, and radiation modality.
  • Radiation modality, chemotherapy, and tumor staging were not significantly associated with swallowing dysfunction.
  • These findings indicate that swallowing function continues to deteriorate over time, even many years after radiation therapy in patients with NPC.
  • Our results indicate that the time elapsed since radiation therapy correlates with the severity of dysphagia in NPC patients.
  • [MeSH-major] Carcinoma / diagnostic imaging. Carcinoma / radiotherapy. Deglutition Disorders / diagnostic imaging. Deglutition Disorders / etiology. Fluoroscopy. Nasopharyngeal Neoplasms / diagnostic imaging. Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy / adverse effects. Video Recording

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  • (PMID = 12825907.001).
  • [ISSN] 0179-051X
  • [Journal-full-title] Dysphagia
  • [ISO-abbreviation] Dysphagia
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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58. Chow E, Payne D, O'Sullivan B, Pintilie M, Liu FF, Waldron J, Warde P, Cummings B: Radiotherapy alone in patients with advanced nasopharyngeal cancer: comparison with an intergroup study. Is combined modality treatment really necessary? Radiother Oncol; 2002 Jun;63(3):269-74

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  • [Title] Radiotherapy alone in patients with advanced nasopharyngeal cancer: comparison with an intergroup study. Is combined modality treatment really necessary?
  • PURPOSE: To examine the outcome of radiotherapy (RT) alone in patients with advanced nasopharyngeal cancer (NPC) and to compare the results with those reported by the Intergroup study 0099 (IGS) comparing RT to combined modality therapy (CMT).
  • MATERIALS AND METHODS: During the period 1985-1992, 198 NPC patients presenting without distant metastatic disease were treated for cure.
  • Of these, 172 had stage III/IV (UICC 1987, 1992).
  • Planned RT was 2 Gy/day fraction to 60-66 Gy to the primary tumor, with 50 and 60 Gy to the node negative and to palpable nodes, respectively.
  • Outcomes included overall survival (OS) and disease-free survival (DFS), defined from the time of registration at our institution.
  • RESULTS: The TNM categories and other prognostic factors were similar to the IGS, though 80% had stage IV compared to 91% in IGS.
  • The 5 year OS and DFS for the 172 patients with stage III/IV disease were 62 and 48%, respectively, as compared to the IGS results of OS 37% and DFS 29% for RT alone, and OS 67% and DFS 58% for the CMT arm of IGS.
  • The surprisingly poor outcome of the IGS/RT control arm may have resulted by chance, suggesting the need for a confirmatory randomized trial to fully establish the role of combined chemotherapy and radiation, as used in the IGS.
  • [MeSH-major] Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Disease-Free Survival. Female. Hong Kong. Humans. Male. Middle Aged. Retrospective Studies

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  • [Copyright] Copyright 2002 Elsevier Science Ireland Ltd.
  • (PMID = 12142090.001).
  • [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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59. 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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60. DeNittis AS, Liu L, Rosenthal DI, Machtay M: Nasopharyngeal carcinoma treated with external radiotherapy, brachytherapy, and concurrent/adjuvant chemotherapy. Am J Clin Oncol; 2002 Feb;25(1):93-5
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  • [Title] Nasopharyngeal carcinoma treated with external radiotherapy, brachytherapy, and concurrent/adjuvant chemotherapy.
  • The standard treatment for advanced nasopharyngeal carcinoma (NPC) has become external beam radiation therapy (EBXRT) 70 Gy/7 weeks + 3 cycles of concurrent cisplatin followed by 2 to 3 cycles of adjuvant cisplatin/5-fluorouracil (5-FU).
  • To our knowledge, this is the first report of the "triple" combination of EBXRT, brachytherapy, and concurrent/adjuvant chemotherapy.
  • All patients had stage III/IV (excluding T4 lesions) NPC.
  • Treatment consisted of EBXRT (64-70 Gy/7 weeks), followed by a brachytherapy boost (6-15 Gy delivered 0.5 cm deep to the mucosa).
  • Chemotherapy consisted of concurrent cisplatin (100 mg/m2) and post-XRT adjuvant cisplatin (80 mg/m2) and 5-FU (1,000 mg/m2/day x 4 days) for 2 cycles.
  • Median EBXRT dose was 66 Gy, and median brachytherapy dose was 9 Gy (median total dose: 75 Gy).
  • The 3-year actuarial survival is 100%.
  • [MeSH-major] Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Brachytherapy. Combined Modality Therapy. Female. Humans. Male. Middle Aged

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  • (PMID = 11823706.001).
  • [ISSN] 0277-3732
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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61. Fournel P, Robinet G, Thomas P, Souquet PJ, Léna H, Vergnenégre A, Delhoume JY, Le Treut J, Silvani JA, Dansin E, Bozonnat MC, Daurés JP, Mornex F, Pérol M, Groupe Lyon-Saint-Etienne d'Oncologie Thoracique-Groupe Français de Pneumo-Cancérologie: Randomized phase III trial of sequential chemoradiotherapy compared with concurrent chemoradiotherapy in locally advanced non-small-cell lung cancer: Groupe Lyon-Saint-Etienne d'Oncologie Thoracique-Groupe Français de Pneumo-Cancérologie NPC 95-01 Study. J Clin Oncol; 2005 Sep 1;23(25):5910-7
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  • [Title] Randomized phase III trial of sequential chemoradiotherapy compared with concurrent chemoradiotherapy in locally advanced non-small-cell lung cancer: Groupe Lyon-Saint-Etienne d'Oncologie Thoracique-Groupe Français de Pneumo-Cancérologie NPC 95-01 Study.
  • PURPOSE: We conducted a phase III study to compare the survival impact of concurrent versus sequential treatment with radiotherapy (RT) and chemotherapy (CT) in unresectable stage III non-small-cell lung cancer (NSCLC).
  • PATIENTS AND METHODS: Patients were randomly assigned to one of the two treatment arms.
  • In the sequential arm, patients received induction CT with cisplatin (120 mg/m2) on days 1, 29, and 57, and vinorelbine (30 mg/m2/wk) from day 1 to day 78, followed by thoracic RT at a dose of 66 Gy in 33 fractions (2 Gy per fraction and 5 fractions per week).
  • In the concurrent arm, the same RT was started on day 1 with two concurrent cycles of cisplatin 20 mg/m2/d and etoposide 50 mg/m2/d (days 1 to 5 and days 29 to 33); patients then received consolidation therapy with cisplatin 80 mg/m2 on days 78 and 106 and vinorelbine 30 mg/m2/wk from days 78 to 127.
  • CONCLUSION: Although not statistically significant, clinically important differences in the median, 2-, 3-, and 4-year survival rates were observed, with a trend in favor of concurrent chemoradiation therapy, suggesting that is the optimal strategy for patients with locally advanced NSCLC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Drug Administration Schedule. Female. Humans. Male. Middle Aged. Survival Analysis. Vinblastine / administration & dosage. Vinblastine / analogs & derivatives

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  • [CommentIn] J Clin Oncol. 2005 Sep 1;23(25):5859-61 [16087952.001]
  • (PMID = 16087956.001).
  • [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; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin; Q6C979R91Y / vinorelbine
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62. Yao K, Takahashi H, Inagi K, Nakayama M, Makoshi T, Nagai H, Okamoto M: Carcinoma of the nasopharynx: analysis of treatment results in 91 patients. Acta Otolaryngol Suppl; 2002;(547):20-4

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

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  • (PMID = 12212588.001).
  • [ISSN] 0365-5237
  • [Journal-full-title] Acta oto-laryngologica. Supplementum
  • [ISO-abbreviation] Acta Otolaryngol Suppl
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Norway
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63. 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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64. Hui EP, Ma BB, Leung SF, King AD, Mo F, Kam MK, Yu BK, Chiu SK, Kwan WH, Ho R, Chan I, Ahuja AT, Zee BC, Chan AT: Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma. J Clin Oncol; 2009 Jan 10;27(2):242-9
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  • [Title] Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma.
  • PURPOSE: To compare the toxicities, tumor control, survival, and quality of life of nasopharyngeal cancer (NPC) patients treated with sequential neoadjuvant chemotherapy followed by concurrent cisplatin-radiotherapy (CRT) or CRT alone.
  • PATIENTS AND METHODS: Previously untreated stage III to IVB NPC were randomly assigned to (1) neoadjuvant docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2) every 3 weeks for two cycles, followed by cisplatin 40 mg/m(2)/wk concurrent with radiotherapy, or (2) CRT alone.
  • RESULTS: From November 2002 to November 2004, 65 eligible patients were randomly assigned to neoadjuvant chemotherapy followed by CRT (n = 34) or CRT alone (n = 31).
  • There was a high rate of grade 3/4 neutropenia (97%) but not neutropenic fever (12%) during neoadjuvant chemotherapy.
  • 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


65. Alieva SB, Tkachëv SI, Matiakin EG, Kondrat'eva AP, Zimina NA, Sakharovskaia VG, Iachmeneva NF, Romanov IS: [A comparison of two modalities of complex chemoradiotherapy for locally advanced nasopharyngeal carcinoma]. Vopr Onkol; 2004;50(6):701-5
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  • [Title] [A comparison of two modalities of complex chemoradiotherapy for locally advanced nasopharyngeal carcinoma].
  • Two modalities of complex chemoradiotherapy for locally advanced nasopharyngeal carcinoma stage III-IV were compared in the treatment of 52 patients.
  • The best results were reported with chemoradiotherapy using two courses: an induction one and an adjuvant cisplatin drugs treatment concurrent with ACOP or 5-FU.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Infusions, Intravenous. Injections, Intravenous. Male. Middle Aged. Neoplasm Staging. Prednisolone / administration & dosage. Radiotherapy, Adjuvant. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 15755067.001).
  • [ISSN] 0507-3758
  • [Journal-full-title] Voprosy onkologii
  • [ISO-abbreviation] Vopr Onkol
  • [Language] rus
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Russia
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; VAP-cyclo protocol
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66. Oh JL, Vokes EE, Kies MS, Mittal BB, Witt ME, Weichselbaum RR, Haraf DJ: Induction chemotherapy followed by concomitant chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal cancer. Ann Oncol; 2003 Apr;14(4):564-9
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  • [Title] Induction chemotherapy followed by concomitant chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal cancer.
  • BACKGROUND: Since 1990, we have treated patients with advanced nasopharyngeal cancer with induction chemotherapy and concomitant chemoradiotherapy.
  • PATIENTS AND METHODS: From 1990 to 1999, 27 patients with locoregionally advanced nasopharyngeal cancer were treated with induction chemotherapy followed by concomitant chemoradiotherapy.
  • Using the American Joint Committee on Cancer's 1992 stage classification, all patients were stage III (11%) or IV (89%).
  • By histology, 63% were poorly differentiated carcinoma and 37% squamous cell carcinoma.
  • Three cycles of induction chemotherapy consisting of cisplatin, 5-fluorouracil, leucovorin and interferon-alpha2b were administered, followed by concomitant chemoradiotherapy consisting of seven cycles of 5-fluorouracil, hydroxyurea and once-daily radiotherapy (FHX) on a week-on week-off schedule.
  • The median radiotherapy dose was 70 Gy.
  • RESULTS: Clinical response to induction chemotherapy was 100%, 54.2% complete response (CR) and 45.8% partial response.
  • Clinical and/or pathological (37% of all patients had post-treatment biopsy with or without neck dissection) CR after FHX was 100%.
  • Four patients died of unrelated illnesses and had no evidence of disease with respect to their nasopharyngeal cancer.
  • Thirty-three per cent of patients required a reduction in the chemotherapy dose due to acute toxicity.
  • CONCLUSIONS: Treatment of locoregionally advanced nasopharyngeal cancer with induction chemotherapy followed by concomitant chemoradiotherapy resulted in excellent overall survival with acceptable toxicity.

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  • [CommentIn] Ann Oncol. 2003 Apr;14(4):508-9 [12649094.001]
  • [CommentIn] Ann Oncol. 2004 Apr;15(4):689; author reply 689-90 [15033682.001]
  • (PMID = 12649102.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Interferon-alpha; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; X6Q56QN5QC / Hydroxyurea
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67. Liu S, Xue Y, Zhang H, Liang JG, Lu XP, Liu XG, Chen SX, Jing NY: [Preliminary study on the value of 99Tc(m)-HL91 imaging in predicting sensitivity to radiotherapy in patients with nasopharyngeal carcinoma]. Zhonghua Zhong Liu Za Zhi; 2007 May;29(5):369-72
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  • [Title] [Preliminary study on the value of 99Tc(m)-HL91 imaging in predicting sensitivity to radiotherapy in patients with nasopharyngeal carcinoma].
  • OBJECTIVE: To investigate the feasibility of 9Tc(m)-HL91 imaging in prediction of 34 radiotherapy sensitivity of naqsopharyngeal cancer( NPC) and its relationship with prognosis.
  • METHODS: patients with NPC confirmed by pathology, staging from II-IVa, underwent 99Tc(m)-HL91 SPECT imaging one week before radiotherapy.
  • 18 of them received adjuvant chemotherapy.
  • The hypoxia in primary nasopharyngeal lesions and cervical lymph node metastases were calculated semi-quantitatively, and compared with clinical findings in medium-term therapy at 4 months and 1 year post therapy. RESULTS:.
  • (1) There was no significant relationship between the total preliminary curative effect of adjuvant chemotherapy and the degree of nasopharyngeal lesion hypoxia (T/Mu, gamma = -0.394, P = 0.145; T/ Ce gamma = -0.510, P = 0.052).
  • But there was a significant difference between the partial curative effect group and significant curative effect group. (2) The degree of NPC regression in the medium-term radiotherapy group was negatively correlated with the degree of hypoxia (T/Mu, gamma = -0.602; T/Ce, gamma = -0.643, P < 0.01). (3) 23 patients had good local control except one case with lung and bone metastasis 4 months post-therapy.
  • The lesions disappeared or not developed in 6 patients (T/Mu 1.30 +/- 0.23, T/Ce 3.61 +/- 0.84).
  • Two patients at stage III and IVa relapsed (T/Mu were 1.40 and 1.27, respectively; T/Ce were 4.10 and 3.85, respectively), there was no significant difference. (4) The degree of lymph node hypoxia had no correlation with the curative effect on medium-term radiotherapy.
  • CONCLUSION: 99 Tc(m)-HL91 hypoxia imaging may predict sensitivity to radiotherapy in patients with NPC, with a potential help to carry out individual therapy.
  • However, further investigation is needed to ascertain whether it could predict the long-time curative effect on NPC radiotherapy.
  • [MeSH-major] Nasopharyngeal Neoplasms / radionuclide imaging. Organotechnetium Compounds. Oximes
  • [MeSH-minor] Adult. Aged. Anoxia. Chemotherapy, Adjuvant. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Particle Accelerators. Preoperative Care / methods. Prognosis. Radiotherapy, High-Energy. Remission Induction. Reproducibility of Results. Tomography, Emission-Computed, Single-Photon

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  • (PMID = 17892134.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Organotechnetium Compounds; 0 / Oximes; 0 / technetium Tc 99m 4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime
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68. Lin S, Lu JJ, Han L, Chen Q, Pan J: Sequential chemotherapy and intensity-modulated radiation therapy in the management of locoregionally advanced nasopharyngeal carcinoma: experience of 370 consecutive cases. BMC Cancer; 2010;10:39
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  • [Title] Sequential chemotherapy and intensity-modulated radiation therapy in the management of locoregionally advanced nasopharyngeal carcinoma: experience of 370 consecutive cases.
  • INTRODUCTION: To investigate the outcome of locoregionally advanced nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) after induction chemotherapy, with or without concomitant chemotherapy.
  • METHODS: Between August 2003 and March 2007, 370 patients with locoregionally advanced NPC were treated with IMRT.
  • Presenting stages were stage IIB in 62, stage III in 197, and stage IVA/B in 111 patients.
  • All patients except for 36 patients with cervical lymphadenopathy of 4 cm or less in diameter received 2 cycles of cisplatin-based neoadjuvant chemotherapy.
  • Forty-eight patients received cisplatin-based concurrent chemotherapy as well.
  • RESULTS: With a median follow-up time of 31 months (range 5 to 61 months), the 3-year local control, regional control, metastasis-free survival (MFS), disease-free survival (DFS) and overall survival (OS) rates were 95%, 97%, 86%, 81% and 89%, respectively.
  • T-classification and concurrent chemotherapy were not significant prognostic factors for local/regional control, MFS, DFS, or OS.
  • Subgroup analysis revealed that concurrent chemotherapy provided no significant benefit to IMRT in locoregionally advanced NPC, but was responsible for higher rates of grade 3 or 4 acute toxicities (50% vs. 29.8%, P < 0.005).
  • However, two patients treated with IMRT and neoadjuvant but without concurrent and adjuvant chemotherapy died of treatment related complications.
  • CONCLUSION: IMRT following neoadjuvant chemotherapy produced a superb outcome in terms of local control, regional control, MFS, DFS, and OS rates in patients with stage IIB to IVB NPC.
  • Effective treatment strategy is urgently needed for distant control in patients diagnosed with locoregionally advanced NPC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Radiotherapy / adverse effects. Survival Rate. Treatment Outcome

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  • (PMID = 20146823.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2836300
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69. 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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70. 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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71. 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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72. 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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73. Geara FB, Nasr E, Tucker SL, Brihi E, Zaytoun G, Hadi U, Salem Z, El Saghir N, Issa P, Shamseddine A: Nasopharyngeal cancer in the Middle East: experience of the American University of Beirut Medical Center. Int J Radiat Oncol Biol Phys; 2005 Apr 1;61(5):1408-15
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  • [Title] Nasopharyngeal cancer in the Middle East: experience of the American University of Beirut Medical Center.
  • PURPOSE: To review the data of nasopharyngeal carcinoma (NPC) treated at the American University of Beirut Medical Center and reflect on the characteristics and treatment outcome of NPC in the Middle East compared with those of Western countries and countries in which NPC is endemic.
  • METHODS AND MATERIALS: Between 1966 and 1998, 151 patients with the diagnosis of NPC received definitive radiotherapy at the American University of Beirut Medical Center.
  • Most (60%) patients (n = 91) had Stage IV disease, 27% had Stage III, and 13% had Stage I or II disease; nodal disease was present in 117 patients (77%).
  • The pathologic type was predominantly lymphoepithelioma or World Health Organization type III (95 patients, 63%).
  • Treatment consisted of definitive radiotherapy alone for 116 patients (77%).
  • All others received induction chemotherapy, primarily with cisplatin-containing regimens.
  • The median radiation dose was 66 Gy (range, 47-73 Gy) to the primary and 67 Gy (range, 49-85 Gy) to involved neck nodes given at 2 Gy/fraction.
  • Using univariate analyses, the following factors significantly affected DFS: node size (<3 vs. 3-6 vs. >6 cm; p = 0.01), node level (upper vs. mid vs. lower neck; p = 0.004), and duration of radiotherapy (p = 0.002).
  • However, T stage, age, gender, radiation dose, use of chemotherapy, and histologic features had no statistically significant influence on DFS.
  • T stage, N stage, and histologic features were statistically significant variables for local control in the univariate analyses.
  • Using a Cox regression model, N stage (N1-N2 vs. N3; relative risk 2.09, p = 0.004) was identified as an independent variable for DFS, and N stage and pathologic features were identified as independent variables for local control.
  • Distant metastases were only affected by N stage (upper-mid vs. lower neck; p = 0.004).
  • CONCLUSION: Our results indicate that the characteristics of NPC patients in Lebanon and their parameters of outcome are comparable to those reported in Western series, particularly for the relative frequency and effect of lymphoepithelial histologic type.
  • Because of potential confounding factors, no definite conclusions about induction chemotherapy could be drawn from this retrospective study.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Analysis of Variance. Child. Female. Humans. Lebanon. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Radiation Injuries / etiology. Radiotherapy Dosage. Treatment Outcome

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  • (PMID = 15817344.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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74. Rodriguez-Galindo C, Wofford M, Castleberry RP, Swanson GP, London WB, Fontanesi J, Pappo AS, Douglass EC: Preradiation chemotherapy with methotrexate, cisplatin, 5-fluorouracil, and leucovorin for pediatric nasopharyngeal carcinoma. Cancer; 2005 Feb 15;103(4):850-7
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  • [Title] Preradiation chemotherapy with methotrexate, cisplatin, 5-fluorouracil, and leucovorin for pediatric nasopharyngeal carcinoma.
  • BACKGROUND: Nasopharyngeal carcinoma (NPC) is rare in children, accounting for <1% of all cases.
  • Treatment most commonly includes radiotherapy but long-term side effects of such treatment can produce devastating cosmetic and functional sequelae in children.
  • Chemotherapy may help to decrease the radiotherapy dose and limit the side effects of local therapies.
  • However, little is known regarding the chemosensitivity of NPC tumors in pediatric patients.
  • METHODS: Patients with American Joint Committee on Cancer (AJCC) Stage I/II disease (Stratum 01) received irradiation only.
  • Patients with AJCC Stage III/IV disease (Stratum 02) received 4 courses of preradiation chemotherapy comprising methotrexate (120 mg/m2) on Day 1, with cisplatin (100 mg/m2) 24 hours later, 5-fluorouracil 1000 mg/m2 per day as a continuous infusion for 3 days, and leucovorin 25 mg/m2 every 6 hours for 6 doses.
  • Irradiation was given after chemotherapy and consisted of 50.4 gray (Gy) to the upper neck and 45.0 Gy to the lower neck, with a boost to the primary tumor and positive lymph nodes for a total dose of 61.2 Gy.
  • Two-thirds of the patients developed Grade 3-4 mucositis during chemotherapy.
  • The overall response rate to induction chemotherapy was 93.7%.
  • CONCLUSIONS: The current study demonstrated that childhood NPC was sensitive to chemotherapy and that chemotherapy before irradiation was feasible.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma / drug therapy. Nasopharyngeal Neoplasms / drug therapy. Nasopharyngeal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Antineoplastic Agents / adverse effects. Cisplatin / adverse effects. Combined Modality Therapy. Epstein-Barr Virus Infections. Fluorouracil / adverse effects. Herpesvirus 4, Human. Humans. Leucovorin / adverse effects. Methotrexate / adverse effects. Survival Rate

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  • [Copyright] Copyright (c) 2005 American Cancer Society.
  • (PMID = 15641027.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; YL5FZ2Y5U1 / Methotrexate
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75. 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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76. 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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77. Varan A, Ozyar E, Corapçioğlu F, Köksal Y, Aydin B, Yazici N, Akyüz C, Büyükpamukçu M: Pediatric and young adult nasopharyngeal carcinoma patients treated with preradiation Cisplatin and docetaxel chemotherapy. Int J Radiat Oncol Biol Phys; 2009 Mar 15;73(4):1116-20
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  • [Title] Pediatric and young adult nasopharyngeal carcinoma patients treated with preradiation Cisplatin and docetaxel chemotherapy.
  • PURPOSE: To evaluate treatment results for pediatric and young adult (aged <21 years) patients with nonmetastatic nasopharyngeal carcinoma treated with neoadjuvant cisplatin + docetaxel and radiotherapy.
  • METHODS AND MATERIALS: Ten patients with nasopharyngeal carcinoma who received diagnoses between 2004 and 2007 were treated with four cycles of cisplatin 100 mg/m(2) + docetaxel 75 mg/m(2) on Day 1 with premedication every 3 weeks.
  • All patients were treated with fractionated external beam radiotherapy after chemotherapy to a median dose of 59.4 Gy (range, 54-59.4 Gy) to the primary disease and 40 Gy to the supraclavicular field with the clavicles shielded.
  • Five children were monitored with serum EBV DNA quantification at diagnosis, after each cycle of chemotherapy, before radiotherapy, and at follow-up.
  • Stage distribution was as follows: 2 patients had Stage IIb disease, 2 had Stage III, 4 had Stage IVa, and 2 had Stage IVb disease.
  • After cisplatin+docetaxel chemotherapy 1 patient had a complete response, 5 had a partial response, 3 had stable disease, and 1 had disease progression.
  • No major chemotherapy toxicity was observed.
  • The EBV DNA titers were higher in 2 of the 5 monitored patients at the time of diagnosis.
  • CONCLUSION: As neoadjuvant chemotherapy before radiotherapy, the cisplatin+docetaxel combination is safe for use in the treatment of childhood nasopharyngeal carcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Nasopharyngeal Neoplasms / drug therapy. Neoadjuvant Therapy / methods. Taxoids / administration & dosage
  • [MeSH-minor] Adolescent. Child. Cisplatin / administration & dosage. DNA, Viral / isolation & purification. Drug Administration Schedule. Female. Herpesvirus 4, Human / genetics. Humans. Male. Neoplasm Staging. Retrospective Studies. Survival Analysis. Young Adult

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  • (PMID = 18786778.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Viral; 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin
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78. 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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79. Wong FC, Ng AW, Lee VH, Lui CM, Yuen KK, Sze WK, Leung TW, Tung SY: Whole-field simultaneous integrated-boost intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys; 2010 Jan 1;76(1):138-45
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  • [Title] Whole-field simultaneous integrated-boost intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma.
  • PURPOSE: To retrospectively review the outcomes of our patients with newly diagnosed nondisseminated nasopharyngeal carcinoma treated with intensity-modulated radiotherapy using a whole-field simultaneous integrated-boost technique.
  • The distribution of disease by stage was Stage IA in 10.9%, Stage IIA in 2.3%, Stage IIB in 21.7%, Stage III in 41.1%, Stage IVA in 14.9%, and Stage IVB in 9.1%.
  • Of the 175 patients, 2 (1.2%), 10 (5.7%), and 163 (93.1%) had World Health Organization type I, II, and III histologic features, respectively.
  • We prescribed 70 Gy, 60 Gy, and 54 Gy delivered in 33 fractions within 6.5 weeks at the periphery of three planning target volumes (PTV; PTV70, PTV60, and PTV54, respectively).
  • Of the 175 patients, 46 with early T-stage disease received a brachytherapy boost, and 127 with advanced local or regional disease received chemotherapy.
  • Cox regression analysis showed Stage N2-N3 disease (p = .029) and PTV (p = .024) to be independent factors predicting a greater risk of distant failure and poor overall survival, respectively.
  • Grade 3 acute mucositis/pharyngitis occurred in 23.4% of patients, and Stage T4 disease was the only significant predictor of mucositis/pharyngitis (p = .021).
  • CONCLUSION: Whole-field simultaneous integrated-boost intensity-modulated radiotherapy with a dose >70 Gy achieved excellent locoregional control, without an excess incidence of severe, acute mucositis/pharyngitis, in the present study.
  • Strategies for using such highly conformal treatment for patients with a large tumor and late N-stage disease are potential areas of investigation for future studies.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brachytherapy / methods. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Mucositis / etiology. Neoplasm Staging. Pharyngitis / etiology. Radiotherapy Dosage. Regression Analysis. Remission Induction. Retrospective Studies. Treatment Outcome. Tumor Burden. Young Adult

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  • (PMID = 19646824.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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80. Lin S, Pan J, Han L, Zhang X, Liao X, Lu JJ: Nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy: report on the 3-year outcome of a prospective series. Int J Radiat Oncol Biol Phys; 2009 Nov 15;75(4):1071-8
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  • [Title] Nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy: report on the 3-year outcome of a prospective series.
  • PURPOSE: To evaluate the efficacy of intensity-modulated radiotherapy (IMRT) using reduced clinical target volumes (CTV) in the treatment of nasopharyngeal carcinoma (NPC).
  • METHODS AND MATERIALS: Between August 2003 and December 2006, 323 patients with NPC were treated with IMRT according to this institutional protocol.
  • Presenting stages were Stage II in 63, Stage III in 166, and Stage IVA/B in 94 patients.
  • High-risk CTV encompassed gross tumor volume and entire nasopharyngeal mucosa with a margin.
  • Uninvolved neck nodes were delineated according to the Radiation Therapy Oncology Group (RTOG)/European Organisation for Research and Treatment of Cancer (EORTC) consensus excluding the deep jugular (i.e., lymph nodes in retrostyloid space above C1 vertebra) and submental nodes.
  • Patients with locoregionally advanced diseases also received cisplatin-based chemotherapy.
  • RESULTS: With a median follow-up of 30 months (range, 4-53 months), 12, 6, and 26 patients had developed local, regional, and distant failures, respectively.
  • The 3-year estimated local control, regional control, metastasis-free survival, disease-free survival and overall survival were 95%, 98%, 90%, 85%, and 90%, respectively.
  • Multivariate analyses revealed that T-classification had no predictive value for outcome, whereas N-classification was significant for predicting metastasis-free (p = 0.005) and overall survival (p =0.006).
  • Ten patients (7.8%) experienced Grade II xerostomia at 24 months after treatment.
  • No Grade III or IV late-toxicities were observed.
  • Two patients died of treatment-induced complications.
  • CONCLUSION: The IMRT approach using a reduced target volume provided favorable outcome for NPC with acceptable toxicity.
  • [MeSH-major] Nasopharyngeal Neoplasms / radiotherapy. Radiotherapy, Intensity-Modulated / methods

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  • (PMID = 19362784.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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81. 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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82. Katz TS, Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Villaret DB: Malignant tumors of the nasal cavity and paranasal sinuses. Head Neck; 2002 Sep;24(9):821-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To evaluate the role of radiation therapy in patients with nasal cavity and paranasal sinus tumors.
  • MATERIALS AND METHODS: Between October 1964 and July 1998, 78 patients with malignant tumors of the nasal cavity (48 patients), ethmoid sinus (24 patients), sphenoid sinus (5 patients), or frontal sinus (1 patient) were treated with curative intent by radiation therapy alone or in the adjuvant setting.
  • There were 25 squamous cell carcinomas, 14 undifferentiated carcinomas, 31 minor salivary gland tumors (adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma), 8 esthesioneuroblastomas, and 1 transitional cell carcinoma.
  • Forty-seven patients were treated with irradiation alone, 25 with surgery and postoperative irradiation, 2 with preoperative irradiation and surgery, and 4 with chemotherapy in combination with irradiation with or without surgery.
  • RESULTS: The 5-year actuarial local control rate for stage I (limited to the site of origin; 22 patients) was 86%; for stage II (extension to adjacent sites (eg, adjacent sinuses, orbit, pterygomaxillary fossa, nasopharynx; 21 patients) was 65%; and for stage III (destruction of skull base or pterygoid plates, or intracranial extension; 35 patients) was 34%.
  • Of the 67 (86%) patients who were initially seen with node-negative disease, 39 (58%) received no elective neck treatment, and 28 (42%) received elective neck irradiation.
  • Of the 39 patients who received no elective neck treatment, 33 (85%) did not experience recurrence in the neck compared with 25 (89%) of 28 patients who received elective neck irradiation.
  • Most patients who received elective neck irradiation (57%) had stage III disease.
  • CONCLUSION: Surgery and postoperative radiation therapy may result in improved local control, absolute survival, and complications when compared with radiation therapy alone.
  • Elective neck irradiation is probably unnecessary for patients with early-stage disease.
  • [MeSH-major] Carcinoma / therapy. Nasal Cavity. Nose Neoplasms / therapy. Paranasal Sinus Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Blindness / etiology. Blindness / prevention & control. Cause of Death. Chemotherapy, Adjuvant. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Metastasis. Neoplasm Staging. Osteoradionecrosis / etiology. Postoperative Care. Preoperative Care. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Risk Factors. Survival Rate. United States / epidemiology

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  • [Copyright] Copyright 2002 Wiley Periodicals, Inc. Head Neck 24: 821-829, 2002
  • (PMID = 12211046.001).
  • [ISSN] 1043-3074
  • [Journal-full-title] Head & neck
  • [ISO-abbreviation] Head Neck
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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83. Li P, Ai P, Chen L, Yang Y, Li Z, Zhang H, Xu Y, Hong Y, Hao D: [Analysis on clinical data of 677 death cases with nasopharyngeal carcinoma]. Lin Chuang Er Bi Yan Hou Ke Za Zhi; 2002 Jan;16(1):15-6
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  • [Title] [Analysis on clinical data of 677 death cases with nasopharyngeal carcinoma].
  • OBJECTIVE: To study the death causes in 677 patients with nasopharyngeal carcinoma (NPC).
  • METHOD: The clinical data of 677 death cases with NPC hospitalized in our department from 1974 to 1990 were analysed.
  • The main age stage was from forty to sixty.
  • The pathological type was mostly poorly differentiated squamous cell carcinoma.
  • The cases with stage III-IV disease were account for 81.3%.
  • The patients treated by radiotherapy combined with chemotherapy survived longer than those treated by radiotherapy alone (P < 0.05).
  • The majority of the patients died of distal metastasis (372, 54.9%) and local-regional lymph node uncontrolled (142, 20.9%) after treatment.
  • CONCLUSION: The main death causes of the patients with NPC in our investigation were distal metastasis and local-regional recurrence.
  • The treatment of radiotherapy plus chemotherapy probably increases survival time and reduces the death rate in patients with NPC.
  • [MeSH-major] Carcinoma, Squamous Cell / mortality. Nasopharyngeal Neoplasms / mortality
  • [MeSH-minor] Adolescent. Adult. Aged. Cause of Death. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local / mortality

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  • (PMID = 11944472.001).
  • [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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84. 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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85. 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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86. 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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87. 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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88. Galiana R, Boladeras A, Mesía R, Gómez J, de Juan A, Mañós M, Nogués J, Navarro V, Guedea F: Twice-a-day radiotherapy for head and neck cancer: the Catalan Institute of Oncology experience. Radiother Oncol; 2002 Jul;64(1):19-27

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Twice-a-day radiotherapy for head and neck cancer: the Catalan Institute of Oncology experience.
  • PURPOSE: The purpose of this work is to evaluate the contribution of hyperfractionated radiotherapy (RT) in head and neck cancer by sub-localisation.
  • PATIENTS AND METHODS: From 1992 to 1999, 318 patients with squamous head and neck tumours treated by hyperfraction RT were analysed according to their sub-localisation and stage.
  • Fractions used were 1.2 Gy twice-a-day with a curative intent on all patients, to a total mean dose of 79.14 Gy.
  • Treatment protocols by localisation were: larynx: 55 patients with T2N0 and T1-2N1 tumours treated with only RT and 27 patients with T3N0-1 in complete remission after three cycles of induction chemotherapy (ICT); hypopharynx: 29 patients with T2-4N0-2b resectable tumors in response to three cycles of ICT; oropharynx: 48 patients with T2-3N0-1 and T1N1 tumours treated with only RT; 34 patients with nasopharynx tumours treated with RT and three cycles of ICT if T4 or >N1; finally, 125 patients with non-surgical tumours of any localisation treated with four cycles of induction CT and RT.
  • RESULTS: LARYNX: Actuarial local control (LC), disease-free survival (DFS) and overall survival (OS) at 5 years were 78, 73 and 48%, respectively, in T2 tumours and 75, 72 and 60% in stage III disease.
  • NASOPHARYNX: Actuarial LC, DFS and OS at 5 years were 78, 72 and 78%, respectively.
  • NON-SURGICAL TUMORS: Actuarial LC, DFS and OS at 5 years were 39, 33 and 19%, respectively.
  • Only patients with nasopharynx tumours had a low incidence of second tumours.
  • CONCLUSIONS: Twice-a-day external RT can be effectively managed in patients with head and neck cancer.
  • Second neoplasm and intercurrent diseases become an important problem in low and medium stages whereas disease recurrences is the main problem in advanced stages.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Dose Fractionation. Otorhinolaryngologic Neoplasms / radiotherapy

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  • [Copyright] Copyright 2002 Elsevier Science Ireland Ltd.
  • (PMID = 12208570.001).
  • [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
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89. 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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90. 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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91. 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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92. 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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93. Umeda M, Komatsubara H, Ojima Y, Minamikawa T, Shigeta T, Shibuya Y, Yokoo S, Komori T: Lack of survival advantage in patients with advanced, resectable squamous cell carcinoma of the oral cavity receiving induction chemotherapy with cisplatin (CDDP), docetaxel (TXT) and 5-fluorouracil (5FU). Kobe J Med Sci; 2004;50(5-6):189-96
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  • [Title] Lack of survival advantage in patients with advanced, resectable squamous cell carcinoma of the oral cavity receiving induction chemotherapy with cisplatin (CDDP), docetaxel (TXT) and 5-fluorouracil (5FU).
  • Cisplatin-based neoadjuvant chemotherapy (NAC) has been reported to increase survival of patients with nasopharyngeal carcinoma, and organ preservation in those with laryngeal carcinoma, but its efficacy for other head and neck carcinomas is still controversial.
  • We examined the effects of NAC for patients with stage III-IV squamous cell carcinoma of the oral cavity.
  • The 3-year survival rate was 29.6% in the NAC group and 81.5% in the control group.
  • Although any valid conclusions could not be drawn because of the small number of patients examined here, NAC with CDDP, TXT and 5FU offered no advantages over standard treatment for advanced oral cancer in terms of survival.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Mouth Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoadjuvant Therapy. Prognosis. Survival Rate. Taxoids / administration & dosage


94. 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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95. 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

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  • (PMID = 17202944.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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96. Oksüz DC, Meral G, Uzel O, Cağatay P, Turkan S: Reirradiation for locally recurrent nasopharyngeal carcinoma: treatment results and prognostic factors. Int J Radiat Oncol Biol Phys; 2004 Oct 1;60(2):388-94
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  • [Title] Reirradiation for locally recurrent nasopharyngeal carcinoma: treatment results and prognostic factors.
  • PURPOSE: To analyze the results and evaluate the prognostic factors in the retreatment of locally recurrent nasopharyngeal carcinoma.
  • METHODS AND MATERIALS: Forty-one patients with locally recurrent nasopharyngeal carcinoma, who were reirradiated between 1979 and 2000, were retrospectively analyzed.
  • Histologically, 9 tumors (22%) were World Health Organization (WHO) I, 17 (41.5%) WHO II, and 15 (36.5%) WHO III.
  • According to the 1998 TNM staging system of the American Joint Committee on Cancer, the recurrent disease was Stage I in 5 (12.2%), Stage II in 11 (26.8%), Stage III in 6 (14.6%), and Stage IV in 19 (46.4%) patients.
  • Treatment was delivered with 4-6 MV X-rays or Co-60 gamma rays.
  • The median reirradiation dose was 50 Gy.
  • Treatment was delivered at 1.8-2 Gy/fraction daily, 5 days a week.
  • Chemotherapy was used in 41.5% of the patients.
  • For overall survival age, total reirradiation dose, stage, T stage were significant.
  • On multivariate analysis only total dose (p = 0.005) remained significant for local progression-free rate and total reirradiation dose (p = 0.02), interval to recurrence (p = 0.03), stage (p = 0.018) were significant for overall survival.
  • CONCLUSIONS: Early diagnosis of local recurrence and high-dose reirradiation (60 Gy) are crucial for improving the local control and survival.
  • [MeSH-major] Carcinoma / radiotherapy. Nasopharyngeal Neoplasms / radiotherapy. Neoplasm Recurrence, Local / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Analysis of Variance. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Proportional Hazards Models. Radiation Injuries / etiology. Radiotherapy Dosage. Remission Induction. Retrospective Studies

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  • (PMID = 15380570.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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97. 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

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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98. Abitbol A, Abdel-Wahab M, Harvey M, Lewin A, Troner M, Hamilton-Nelson K, Wu J, Markoe A: Phase II study of tolerance and efficacy of hyperfractionated radiation therapy and 5-fluorouracil, cisplatin, and paclitaxel (taxol) and amifostine (ethyol) in head and neck squamous cell carcinomas: A-3 protocol. Am J Clin Oncol; 2005 Oct;28(5):449-55
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  • [Title] Phase II study of tolerance and efficacy of hyperfractionated radiation therapy and 5-fluorouracil, cisplatin, and paclitaxel (taxol) and amifostine (ethyol) in head and neck squamous cell carcinomas: A-3 protocol.
  • 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 hyperfractionated radiation (74.4 Gy at twice-daily fractions of 1.2 Gy) in combination with a 5-fluorouracil, cisplatin, paclitaxel regimen, and an amifostine infusion.
  • [MeSH-major] Amifostine / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / radiotherapy. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / radiotherapy
  • [MeSH-minor] Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Paclitaxel / administration & dosage

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  • (PMID = 16199982.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] M487QF2F4V / Amifostine; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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99. 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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100. 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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