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Treatment outcomes for radiotherapy alone are comparable with neoadjuvant chemotherapy followed by radiotherapy in early-stage nasopharyngeal carcinoma.
Laryngoscope 2008; 118(4):663-70L

Abstract

OBJECTIVES

To analyze the impact of neoadjuvant chemotherapy (CT) on the treatment of early-stage nasopharyngeal carcinoma (NPC) as compared with radiotherapy (RT) alone.

METHODS

We analyzed retrospectively the outcome of 60 previously untreated and histologically confirmed early-stage NPC patients treated with either RT alone or with neoadjuvant CT followed by RT (CT/RT) at the Seoul National University Hospital between 1986 and 2004. Neoadjuvant CT consisted of three cycles with 5-fluourouracil and cisplatin. RT was given to the nasopharynx and neck nodes. The median dose to the primary site, involved nodes, and elective nodes was 70.2 Gy, 63 Gy, and 45 Gy, respectively. According to the 1997 American Joint Committee on Cancer staging system, 9 patients had stage I or IIA disease, and 22 patients had stage IIB disease in the RT group. For the CT/RT group, 8 patients had stage I or IIA disease, and 21 patients had stage IIB disease. The median follow-up for all patients was 124.5 (range, 5-239) months.

RESULTS

The 5-year locoregional failure-free (LRFF), distant metastasis-free (DMF), disease-free survival (DFS), and overall survival (OS) rate was 84%, 93%, 81%, and 84% for the RT group and 77%, 86%, 71%, and 79% for the CT/RT group, respectively. There were no significant differences in LRFF (P = .728), DMF (P = .433), DFS (P = .562), and OS (P = .625) rates between the RT and CT/RT groups. Multivariate analysis revealed that delaying RT for more than 81 days was significantly associated with an increased risk of locoregional failure in the subgroup of patients with stage IIB disease (P = .044).

CONCLUSIONS

In our retrospective analysis, the use of neoadjuvant CT showed no additional benefit to treatment with RT alone. Neoadjuvant CT may cause deleterious effect on stage IIB disease by delaying RT.

Authors+Show Affiliations

Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18216741

Citation

Song, Chang Hoon, et al. "Treatment Outcomes for Radiotherapy Alone Are Comparable With Neoadjuvant Chemotherapy Followed By Radiotherapy in Early-stage Nasopharyngeal Carcinoma." The Laryngoscope, vol. 118, no. 4, 2008, pp. 663-70.
Song CH, Wu HG, Heo DS, et al. Treatment outcomes for radiotherapy alone are comparable with neoadjuvant chemotherapy followed by radiotherapy in early-stage nasopharyngeal carcinoma. Laryngoscope. 2008;118(4):663-70.
Song, C. H., Wu, H. G., Heo, D. S., Kim, K. H., Sung, M. W., & Park, C. I. (2008). Treatment outcomes for radiotherapy alone are comparable with neoadjuvant chemotherapy followed by radiotherapy in early-stage nasopharyngeal carcinoma. The Laryngoscope, 118(4), pp. 663-70. doi:10.1097/MLG.0b013e3181626cfe.
Song CH, et al. Treatment Outcomes for Radiotherapy Alone Are Comparable With Neoadjuvant Chemotherapy Followed By Radiotherapy in Early-stage Nasopharyngeal Carcinoma. Laryngoscope. 2008;118(4):663-70. PubMed PMID: 18216741.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment outcomes for radiotherapy alone are comparable with neoadjuvant chemotherapy followed by radiotherapy in early-stage nasopharyngeal carcinoma. AU - Song,Chang Hoon, AU - Wu,Hong-Gyun, AU - Heo,Dae Seog, AU - Kim,Kwang Hyun, AU - Sung,Myung-Whun, AU - Park,Charn Il, PY - 2008/1/25/pubmed PY - 2008/6/3/medline PY - 2008/1/25/entrez SP - 663 EP - 70 JF - The Laryngoscope JO - Laryngoscope VL - 118 IS - 4 N2 - OBJECTIVES: To analyze the impact of neoadjuvant chemotherapy (CT) on the treatment of early-stage nasopharyngeal carcinoma (NPC) as compared with radiotherapy (RT) alone. METHODS: We analyzed retrospectively the outcome of 60 previously untreated and histologically confirmed early-stage NPC patients treated with either RT alone or with neoadjuvant CT followed by RT (CT/RT) at the Seoul National University Hospital between 1986 and 2004. Neoadjuvant CT consisted of three cycles with 5-fluourouracil and cisplatin. RT was given to the nasopharynx and neck nodes. The median dose to the primary site, involved nodes, and elective nodes was 70.2 Gy, 63 Gy, and 45 Gy, respectively. According to the 1997 American Joint Committee on Cancer staging system, 9 patients had stage I or IIA disease, and 22 patients had stage IIB disease in the RT group. For the CT/RT group, 8 patients had stage I or IIA disease, and 21 patients had stage IIB disease. The median follow-up for all patients was 124.5 (range, 5-239) months. RESULTS: The 5-year locoregional failure-free (LRFF), distant metastasis-free (DMF), disease-free survival (DFS), and overall survival (OS) rate was 84%, 93%, 81%, and 84% for the RT group and 77%, 86%, 71%, and 79% for the CT/RT group, respectively. There were no significant differences in LRFF (P = .728), DMF (P = .433), DFS (P = .562), and OS (P = .625) rates between the RT and CT/RT groups. Multivariate analysis revealed that delaying RT for more than 81 days was significantly associated with an increased risk of locoregional failure in the subgroup of patients with stage IIB disease (P = .044). CONCLUSIONS: In our retrospective analysis, the use of neoadjuvant CT showed no additional benefit to treatment with RT alone. Neoadjuvant CT may cause deleterious effect on stage IIB disease by delaying RT. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/18216741/Treatment_outcomes_for_radiotherapy_alone_are_comparable_with_neoadjuvant_chemotherapy_followed_by_radiotherapy_in_early_stage_nasopharyngeal_carcinoma_ L2 - https://doi.org/10.1097/MLG.0b013e3181626cfe DB - PRIME DP - Unbound Medicine ER -