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Non-endemic locoregionally advanced nasopharyngeal carcinoma: long-term outcome after induction plus concurrent chemoradiotherapy in everyday clinical practice

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Abstract

The aim of this study was to evaluate the long-term outcome in Caucasian population of a non-endemic area treated for locoregionally advanced nasopharyngeal carcinoma (LA-NPC) with multidrug platinum-based induction plus concurrent chemoradiotherapy (IC/CCRT) in everyday clinical practice setting. Between May 1990 and July 2007, 75 patients with newly diagnosed histologically confirmed LA-NPC were given IC/CCRT. All patients were judged suitable to receive conventional fractionated course of radiotherapy to a dose of 70 Gy in 35 fractions (2 Gy per fraction). The intended chemotherapy regimen consisted in one cycle of induction chemotherapy followed by radiotherapy concomitantly with two cycles of chemotherapy. Each cycle of chemotherapy included cis-platinum, 100 mg/m2, and continuous infusion of 5-fluorouracil, 1,000 mg/m2/d for 5 days. The median follow-up in survivors was 122 months. The complete response rate after CCRT was 90.7 %. The main limiting toxicity was grade 3 and 4 pharyngeal mucositis (46.7 %). Five-year cumulative rate of locoregional control (LRC), distant control (DC), overall survival (OS), and event-free survival (EFS) was 80.1, 82.2, 72.0, and 66.7 %, respectively. Ten-year cumulative rate of LRC, DC, OS, and EFS was 73.4, 73.8, 57.1, and 55.2 %, respectively. At multivariate analysis advanced N category and low hemoglobin levels at baseline were found to be independent predictors for both worse OS and EFS. In everyday clinical practice, treating LA-NPC with cisplatin-based IC/CCRT was relatively safe and long-term effective.

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Authors and Affiliations

  1. Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso Regional Hospital, Piazzale Ospedale 1, 31100, Treviso, Italy

    Paolo Boscolo-Rizzo, Monica Mantovani, Valentina Lupato & Maria Cristina Da Mosto

  2. Head and Neck Department, University of Trieste, Trieste, Italy

    Giancarlo Tirelli & Giacomo Spinato

  3. Department of Radiation Oncology, Treviso Regional Hospital, Treviso, Italy

    Vittorio Baggio & Alessandro Gava

Authors
  1. Paolo Boscolo-Rizzo
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  2. Giancarlo Tirelli
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  3. Monica Mantovani
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  4. Vittorio Baggio
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  5. Valentina Lupato
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  8. Maria Cristina Da Mosto
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Correspondence to Paolo Boscolo-Rizzo.

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Boscolo-Rizzo, P., Tirelli, G., Mantovani, M. et al. Non-endemic locoregionally advanced nasopharyngeal carcinoma: long-term outcome after induction plus concurrent chemoradiotherapy in everyday clinical practice. Eur Arch Otorhinolaryngol 272, 3491–3498 (2015). https://doi.org/10.1007/s00405-014-3369-8

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  • DOI: https://doi.org/10.1007/s00405-014-3369-8

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