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Korean Journal of Head & Neck Oncology 2006;22(2):123-129.
Published online November 30, 2006.
Radiation Therapy Combined with Cisplatin Based Chemotherapy for the Patients with Locally Advanced Nasopharyngeal Cancer
Seok Hyun Son;Ji Yoon Kim;Yeon Sil Kim;Sung Whan Kim;Seong Kwon Mun;Seung Ho Cho;Young Hak Park;Young Seon Hong
국소 진행된 비인강암의 방사선-항암제 병용요법
손석현;김지윤;김연실;김성환;문성권;조승호;박영학;홍영선
Abstract
Objective :This retrospective study was designed to evaluate the anti-tumor efficacy and toxicities of the radia-tion therapy(RT) combined with cisplatin-based chemotherapy in locally advanced nasopharyngeal cancer(NPC). Materials and Methods :Fifty three patients with locally advanced NPCs(AJCC stage II, III, IV) received curative RT and cisplatin-based chemotherapy. Duration of follow-up ranged from 5.5 to 201 months(median 50.8 months). Nineteen patients(35.8%) were treated with induction chemotherapy including cisplatin 100mg/m 2 for 1 day and 5-fluorouracil 1g/m 2 for 5 days followed by RT(Induction CTx-RT). Another 34 patients (64.2%) were treated with concurrent chemoradiation(CCRT) using cisplatin 100 mg/m 2 (D1, 22, 43). Results :Thirty-six(67.9%) and 11(20.8%) patients achieved clinical complete response and partial response, respectively. The pattern of failure was as follows:14 locoregional recurrence(26.4%) and 7 distant metastasis (13.2%). Among them, two patients(3.8%) had both locoregional and distant failure. Median overall survival (OS) and progression-free survival(PFS) were 85.5 months and 87.5 months, respectively. Five-year OS rate was 57.1%. The stage(AJCC), tumor response to chemoradiation and T stage were significant prognostic fac-tors for OS(p=0.0113, p=0.0362 and p=0.0469). The stage(AJCC), tumor response to chemoradiation were also significant prognostic factors for PFS(p=0.0329, p=0.0424). Compared to each treatment group(Induction CTx-RT vs. CCRT), there were no significant differences in OS and PFS(p=0.7000, p=0.8261). Grade 3-4 mucositis, nausea/vomiting and hematological toxicities were noticed in 35.8%, 11.3% and 13.2%, respec-tively. Delayed RT over 2 weeks was inevitable in 26.5%. Seventeen patients(50%) successfully completed planned 3 courses of cisplatin in CCRT group. Conclusions :RT combined with cisplatin-based chemotherapy in locally advanced NPC showed high res-ponse rate, good locoregional control, and survival rate. As expected, frequency of acute toxicities increased, and the patient’s compliance to treatment was need to be improved. Although our data could not show additional survival benefit of CCRT compare to that of induction chemotherapy followed by RT, patients’ accrual and further follow-up are required due to limitation of retrospective study.
Key Words: Nasopharyngeal cancer, Chemoirradiation, Cisplatin, Radiation


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