Cancer Res Treat.  2008 Jun;40(2):62-70.

Treatment Outcome of Cisplatin-based Concurrent Chemoradiotherapy in the Patients with Locally Advanced Nasopharyngeal Cancer

• Kim TH
• Ko YH
• Lee MA
• Kim BS
• Chung SR
• Yoo IR
• Jung CK
• Kim YS
• Kim MS
• Sun DI
• Hong YS
• Lee KS
• Kang JH

Abstract

PURPOSE: The standard treatment of locally advanced nasopharyngeal cancer is a concurrent chemoradiotherapy (CCRT), and cisplatin has been used as the most popular chemotherapeutic agent. But many different doses and schedules for cisplatin administration such as daily, weekly and 3 week cycles have been proposed. We compared and analyzed the tumor response, the overall survival, the toxicity and the chemotherapy dose intensity in the patients with locally advanced nasopharyngeal cancer who were treated with CCRT.
MATERIALS AND METHODS
We performed a retrospective study on 55 patients with locally advanced nasopharyngeal cancer, and they were treated with CCRT as a front-line treatment from Jan 1996 to Jun 2007 at Kangnam Saint Mary's Hospital.
RESULTS
The patients had a median age of 53 years (range: 19~75 years). Of the total 55 patients, a 3-week cycle of 100mg cisplatin was administered in 31 patients and 30 mg weekly cisplatin was administered in 24 patients combined with radiotherapy. Twenty one patients had a complete response and four patients had a partial response for a response rate of 71.4% (95% CI: 59.5~83.3) after CCRT and followed by adjuvant chemo-therapy. The complete response rates for the 30 mg and 100 mg cisplatin groups were 72.7% (95% CI: 54.9~90.5) and 54.2% (95% CI: 36.7~71.7), respectively (p= 0.23). The duration of CCRT in the 100mg cisplatin group was significantly longer than that of the 30mg cisplatin group (11.1+/-2.9 weeks vs. 9.0+/-1.2 weeks, p= 0.003). The major deviation group, which was defined as prolongation of the radiotherapy duration for more than 2 weeks, had a significantly lower objective response rate than did the non-deviation group (56.3% vs 84.2%, respectively, p= 0.002). The major severe toxicities were leucopenia (49.1%), pharyngoesophagitis (49.1%), anorexia (43.6%), nausea (41.8%) and vomiting (40%).
CONCLUSIONS
Weekly 30mg cisplatin-based CCRT is a practical, feasible cisplatin schedule for the patients with locally advanced nasopharyngeal cancer in regard to decreasing the interruption of radiation treatment and decreasing the treatment-related acute toxicities.

Keyword

Nasopharyngeal cancer; Chemoradiotherapy; Cisplatin; Objective response rate; Acute toxicities

MeSH Terms

Anorexia
Appointments and Schedules
Chemoradiotherapy
Cisplatin
Humans
Nasopharyngeal Neoplasms
Nausea
Retrospective Studies
Saints
Treatment Outcome
Vomiting
Cisplatin

Figure

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  Fig. 1 Major radiation deviation on cisplatin schedule.

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  Fig. 2 Response difference between major deviation group (MD) and non-deviation group (ND).

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  Fig. 3 Overall survival of nasopharyngeal cancer.

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  Fig. 4 Overall survival time for 3 different WHO histology types.

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