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Cancer Chemotherapy and Pharmacology

, Volume 66, Issue 4, pp 643–651 | Cite as

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

  • Kyong Hwa Park
  • Jeong Sun Kim
  • Yong Park
  • Hee Yeon Seo
  • Young Je Park
  • In Keun Choi
  • Sang Chul Oh
  • Jae Hong Seo
  • Chul Yong Kim
  • Kwang Yoon Jung
  • Sang Won ShinEmail author
  • Yeul Hong Kim
  • Jun Suk Kim
  • Nam Joon Lee
Original Article

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.

Keywords

Nasopharyngeal carcinoma Concomitant chemoradiation Adjuvant chemotherapy Retrospective analysis Korea 

Notes

Acknowledgments

This work was supported by a Korea University Grant.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Kyong Hwa Park
    • 1
  • Jeong Sun Kim
    • 1
  • Yong Park
    • 1
  • Hee Yeon Seo
    • 1
  • Young Je Park
    • 3
  • In Keun Choi
    • 1
  • Sang Chul Oh
    • 1
  • Jae Hong Seo
    • 1
  • Chul Yong Kim
    • 3
  • Kwang Yoon Jung
    • 2
  • Sang Won Shin
    • 1
    Email author
  • Yeul Hong Kim
    • 1
  • Jun Suk Kim
    • 1
  • Nam Joon Lee
    • 4
  1. 1.Division of Oncology/Hematology, Department of Internal MedicineKorea University College of MedicineSeoulKorea
  2. 2.Department of Otorhinolaryngology/Head-and-Neck SurgeryKorea University College of MedicineSeoulKorea
  3. 3.Department of Radiation OncologyKorea University College of MedicineSeoulKorea
  4. 4.Department of RadiologyKorea University College of MedicineSeoulKorea

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