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NASOPHARYNGEAL CARCINOMA

oncology journal "chemoterapy role early on Nasopharyngeal Carcinoma"


chemoterapy clinical trial in Nasopharyngeal Carcinoma
1. Journal of West China University of Medical Sciences 2002-04
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3. A Clinical Trial of Neoadjuvant Chemotherapy plus
Late-course Hyperfractionated Accelerated Radiation
Therapy for Nasopharyngeal Carcinoma
4. Li Ping, Liu Chengwen, Zhang Hong, Yang Yuqiong, Xu Yong, Ai Ping. Department of
Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu
610041, China
5. Objective To evaluate the preliminary therapeutic efficacy and acute radiation toxicity
of neoadjuvant chemotherapy plus late course hyperfractionated accelerated radiation
therapy (LCHART) in the treatment of nasopharyngeal carcinoma (NPC). Methods F
orty three in patients with pathological diagnosis of nonmetastatic (M0) NPC from Se
ptember 1999 to September 2000 were randomized into two groups: one was treated b
y neoadjuvant chemotherapy followed by LCHART (study group, n =23); the other w
as treated by conventional fractionation radiotherapy (control group, n =20); additiona
lly, adjuvant chemotherapy given repeatedly every 3 weeks for 3 4 cycles to both grou
ps was initiated 1 month after radiotherapy. The chemotherapy included Cisplatin 30
mg/m 2 d1 3 and 5 Fu 500mg/m 2 d1 5. The radiotherapy (RT) consisted of two phase
s: 36 0 40.0Gy in 18 20 fraction over 3.5 4 weeks as phase I RT using conventional te
chnique was delivered with two lateral opposing faciocervical fields and an anterior fi
eld of lower neck in the two groups, and then 28.0 32.0Gy in 20 fraction over 2 weeks
was administered as phase II RT using LCHART technique (1.4 1.6Gy per fraction, t
wice daily with interval 6 hours) in the study group and the same doses using conven
tional radiation technique (2.0Gy per fraction once daily) in the control group to the p
rimary tumor with the shrinking field (two lateral opposing facial fields) to avoid exce
ssive irradiation to the spinal cord. Results All study patients went through completely
the therapeutic regimen without interruption of radiotherapy. LCHART was associate
d with significantly more severe mucositis (grade 3 4 oral mucositis was 47.8%), com
pared with that of 20% in the conventional fractionation radiotherapy ( P 0.05). No sig
nificant difference in acute toxicity of skin and hematology was seen between LCHA
RT and conventional fractionation radiotherapy ( P 0.05). The nasopharyngeal and cer
vical lesion complete response rate was 78.26% for the treatment group and 65.00% f
or the control group ( P 0.05) at the end of immediately after radiotherapy. Three mon
ths and six months after radiotherapy, the tumor complete response rates were 95.65%
vs 70.00% ( P 0.05) and 95.65% vs 75 00%( P 0.05) respectively between the study gr
oup and control group. Six months after radiotherapy, the tumor complete response rat
e of locally advanced NPC was 92.13% for the study group and 50.00% for the contro
l group ( P 0.05). Conclusion In comparison with conventional fractionation radiother
apy, neoadjuvant chemotherapy plus LCHART has the advantage of bringing NPC un
der local control, especially in locally advanced NPC, and its acute radiation toxicity i
s tolerable.
6. Key Words Nasopharyngeal carcinoma Neoadjuvant chemotherapy Late
course hyperfractionated accelerated radiation therapy
CateGory Index R739.63

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