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Concurrent chemoradiation followed by adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma in Korea

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Abstract

Purpose

Concomitant approach using cisplatin and 5-fluorouracil (5-FU) has shown an excellent local control rate and significantly reduced distant metastasis in patients with locally advanced nasopharyngeal carcinoma (NPC). However, optimal schedule and dosing of chemotherapy still need to be developed to reduce distant metastasis. This retrospective study was conducted to evaluate the efficacy, toxicity, and tolerability of a concurrent chemoradiation therapy (CCRT) regimen using cisplatin and 5-FU followed by adjuvant chemotherapy (AC) in patients with locoregioanlly advanced NPC.

Methods

Forty-three NPC patients who had AJCC stage T3/T4 or N2/N3 and M0 disease were evaluated. The chemotherapy during CCRT consisted of cisplatin (75 mg/m2 on day 1) plus 5-FU (750 mg/m2/day on day 1–5), delivered every 4 weeks for two cycles. Three cycles of AC were given with cisplatin (75 mg/m2), epirubicin (37.5 mg/m2) on day 1, and bleomycin (7.5 mg/m2 bolus iv. on day 1 followed by 9 mg/m2 on day 1–5 by continuous infusion) every 3 weeks.

Results

The overall response rate after CCRT was 95% (22 CRs and 19 PRs in 43) and 100% (16 CRs and 8 PRs in 24) after AC. Grade 3/4 neutropenia, mucositis, and weight loss were observed during CCRT phase in 18, 44, and 26% of patients, respectively. AC caused grade 3/4 neutropenia and emesis in 12.5 and 20.8% of patients, respectively.

Conclusions

CCRT regimen using cisplatin and 5-FU followed by three cycles of BEC chemotherapy was effective in locally advanced NPC patients, with acceptable and reversible acute toxicities.

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Acknowledgments

This work was supported by a Korea University Grant.

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Authors and Affiliations

  1. Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, 126-1, Anam-dong 5 ga, Seongbuk-gu, Seoul, 136-705, Korea

    Kyong Hwa Park, Jeong Sun Kim, Yong Park, Hee Yeon Seo, In Keun Choi, Sang Chul Oh, Jae Hong Seo, Sang Won Shin, Yeul Hong Kim & Jun Suk Kim

  2. Department of Otorhinolaryngology/Head-and-Neck Surgery, Korea University College of Medicine, Seoul, Korea

    Kwang Yoon Jung

  3. Department of Radiation Oncology, Korea University College of Medicine, Seoul, Korea

    Young Je Park & Chul Yong Kim

  4. Department of Radiology, Korea University College of Medicine, Seoul, Korea

    Nam Joon Lee

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  1. Kyong Hwa Park
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Correspondence to Sang Won Shin.

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Park, K.H., Kim, J.S., Park, Y. et al. Concurrent chemoradiation followed by adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma in Korea. Cancer Chemother Pharmacol 66, 643–651 (2010). https://doi.org/10.1007/s00280-009-1203-6

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  • DOI: https://doi.org/10.1007/s00280-009-1203-6

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