Concurrent Chemotherapy-Radiotherapy Compared With Radiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: Progression-Free Survival Analysis of a Phase III Randomized Trial

DOI Web Site 被引用文献7件
  • A.T.C. Chan
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • P.M.L. Teo
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • R.K. Ngan
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • T.W. Leung
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • W.H. Lau
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • B. Zee
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • S.F. Leung
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • F.Y. Cheung
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • W. Yeo
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • H.H. Yiu
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • K.H. Yu
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • K.W. Chiu
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • D.T. Chan
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • T. Mok
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • K.T. Yuen
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • F. Mo
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • M. Lai
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • W.H. Kwan
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • P. Choi
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.
  • P.J. Johnson
    From the Prince of Wales Hospital, Chinese University of Hong Kong, and Queen Elizabeth Hospital, Hong Kong.

書誌事項

公開日
2002-04-15
DOI
  • 10.1200/jco.2002.08.149
公開者
American Society of Clinical Oncology (ASCO)

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説明

<jats:p> PURPOSE: Nasopharyngeal carcinoma (NPC) is highly sensitive to both radiotherapy (RT) and chemotherapy. This randomized phase III trial compared concurrent cisplatin-RT (CRT) with RT alone in patients with locoregionally advanced NPC. </jats:p><jats:p> PATIENTS AND METHODS: Patients with Ho’s N2 or N3 stage or N1 stage with nodal size ≥ 4 cm were randomized to receive cisplatin 40 mg/m<jats:sup>2</jats:sup> weekly up to 8 weeks concurrently with radical RT (CRT) or RT alone. The primary end point was progression-free survival (PFS). </jats:p><jats:p> RESULTS: Three hundred fifty eligible patients were randomized. Baseline patient characteristics were comparable in both arms. There were significantly more toxicities, including mucositis, myelosuppression, and weight loss in the CRT arm. There were no treatment-related deaths in the CRT arm, and one patient died during treatment in the RT-alone arm. At a median follow-up of 2.71 years, the 2-year PFS was 76% in the CRT arm and 69% in the RT-alone arm (P = .10) with a hazards ratio of 1.367 (95% confidence interval [CI], 0.93 to 2.00). The treatment effect had a significant covariate interaction with tumor stage, and a subgroup analysis demonstrated a highly significant difference in favor of the CRT arm in Ho’s stage T3 (P = .0075) with a hazards ratio of 2.328 (95% CI, 1.26 to 4.28). For T3 stage, the time to first distant failure was statistically significantly different in favor of the CRT arm (P = .016). </jats:p><jats:p> CONCLUSION: Concurrent CRT is well tolerated in patients with advanced NPC in endemic areas. Although PFS was not significantly different between the concurrent CRT arm and the RT-alone arm in the overall comparison, PFS was significantly prolonged in patients with advanced tumor and node stages. </jats:p>

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