Chemoradiotherapy in Patients with Locally Advanced Nasopharyngeal Cancer
Abstract
Objective: To evaluate efficacy of concurrent chemoradiation between cisplatin and carboplatin in nasopharyngeal carcinoma.
Method: 151 patients were enrolled in this study. They were randomized to treat with concurrent chemoradiation in two arms; arm I: cisplatin 100 mg/m' concurrent in day 1, 22, 43 of radiation therapy 70Gy and adjuvant cisplatin 80 mg/m" + 5 5 1000 mg/mi continuous infusion in 4 day monthly for 3 cycles, arm II: carboplatin 100 mg/m weekly concurrent with radiation therapy 70Gy and adjuvant chemotherapy carboplatin AUC5 + 5-FU 1000 mg/m continuous infusion in 4 day for 3 cycles monthly. Overall survival and disease-free survival rate were evaluated by Kaplan-Meier method.
Result: At median time of follow up 24.5 months (range 3 to 60). Seventy-one patients (47.0%) and Eighty patients (53.0%) were randomized in arm I and II, respectively. The Median age of patients was 49 years (range 16 to 70). The 3-yr disease-free survival were 68.7% in arm I and 65.196 in arm II (p=0.9). Carboplatin had lower nephrotoxicity than cisplatin but higher hematologic toxicity especially thrombocytopenia.
Conclusion: The results of two arms is not significant in term of disease-free survival and overall survival. Carboplatin has lower toxicity than cisplatin.
References
Al-Saraaf M, Le Blanc M, Shanker Giri PG et al: chemoradiotherapy vs. radiation therapy in patient with advance nasopharyngeal cancer ; phase III randomized intergroup study 0099. J Clin Oncol 16:1310-1317, 1998
Go RS, Adjai AA: Review of the Comparative Phar- macology and Clinical Activity of Cisplatin and Carboplatin . Journal of Clinical Oncology 17:409- 422, 1999
Douple EB, Richmond RC, O'Hara JA, et al: Cartoplatin as a potentiator of radiation therapy. Cancer Treat Rev 12:111-124, 1985 (suppl A)
Coughlin CT, Richmond RC: Biologic and clinical developments of cisplatin combined with radiation : Concepts, utility, projections for new trials, and the emergence of carboplatin. Semin Oncol 16:31-43, 1989
Calais G, Alfonsi M, Bardet E, et al: Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma.I Natl Cancer Inst 91:2081-2086, 1999
Calais G, Le Floch O: Concomitant radiotherapy and chemotherapy in the treatment of cancer of the upper Respiratory and digestive tracts. Bull Cancer Radiother 83:321-329, 1996
Muggia FM. Overview of carboplatin. Replacing com- plementing and extending the therapeutic horizons of cisplatin. Semin Oncol 16:7 - 13, 1989 (supp. 5)
Eisenberger M,Jacobs M. Simultaneous treatment with single-agent chemotherapy and radiation for locally advanced cancer of head and neck. Semin Oncol 4:41-46, 1992 (supp. 11)
K.Tsuchiya , T. Nishioka, H. Shirato: a randomized trial of concomitant chemoradiotherapy for Head-and -neck cancers: cisplatin (CDDP ) vs. carboplatin (CBDCA ). Proc ASTRO mecting 43:337, 2003 (abstr2215)
Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. I Am Stat Assoc 53:457-481, 1958 11. Fleiss JL, editor. Statistical thods for rates and proportions New York, NY: Wiley:138-143, 1981 2215)
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บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารมะเร็งวิวัฒน์ ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับ และบุคคลากรท่านอื่น ๆ ใน สมาคมฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใดๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
