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Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy.

Publication ,  Journal Article
Jian, JJ-M; Cheng, SH; Tsai, SY-C; Yen, K-CL; Chu, N-M; Chan, K-Y; Tan, T-D; Cheng, JC-H; Lin, Y-C; Leu, S-Y; Hsieh, C-I; Tsou, M-H; Lin, C-Y ...
Published in: Int J Radiat Oncol Biol Phys
June 1, 2002

PURPOSE: When the primary tumor of nasopharyngeal carcinoma (NPC) is treated at the base of skull and intracranium with conventional radiotherapy, the result is generally poor. In this report, we investigated whether hyperfractionated radiotherapy (HFRT) and concomitant chemotherapy (CCT) could achieve better local control and survival in NPC patients with T3 and T4 lesions. PATIENTS AND METHODS: Forty-eight patients (11 T3 and 37 T4 NPC) were treated with HFRT and CCT. HFRT was administered at 1.2 Gy per fraction, two fractions per day, Monday-Friday for 62 fractions for a total dose of 74.4 Gy. Concomitant chemotherapy consisting of cis-diamino-dichloroplatinum (CDDP) alone or CDDP and 5-fluorouracil was delivered simultaneously with radiotherapy during Weeks 1 and 6. Adjuvant chemotherapy consisted of CDDP and 5-fluorouracil for 2 to 3 cycles and was given monthly beginning 1 month after completion of radiation. RESULTS: With a median follow-up of 57 months (range: 28-94 months), the 3-year locoregional control rate was 93%, the disease-free survival rate was 71%, and the overall survival rate was 72%. For T4 patients, the 3-year locoregional control rate was 91%, disease-free survival was 62%, and overall survival was 63%. The major acute toxicity was Grade 3 mucositis in 73% and Grade 2 weight loss in 31% of patients. Fifty percent of patients were tube fed. Most patients tolerated the combined modality treatments relatively well; 88% of patients completed their radiation treatment within 8 weeks. CONCLUSION: HFRT and CCT for T3 and T4 NPC were associated with excellent local control and improved survival. The treatment-related toxicity was acceptable and reversible. We would recommend using HFRT with CCT for advanced T-stage NPC if the three-dimensional conformal radiation planning shows a significant portion of the brainstem to be inside the treatment field.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

June 1, 2002

Volume

53

Issue

2

Start / End Page

344 / 352

Location

United States

Related Subject Headings

  • Weight Loss
  • Survival Rate
  • Stomatitis
  • Patient Compliance
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Metastasis
  • Nasopharyngeal Neoplasms
  • Mouth Mucosa
  • Middle Aged
 

Citation

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ICMJE
MLA
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Jian, J.-M., Cheng, S. H., Tsai, S.-C., Yen, K.-C., Chu, N.-M., Chan, K.-Y., … Huang, A. T. (2002). Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy. Int J Radiat Oncol Biol Phys, 53(2), 344–352. https://doi.org/10.1016/s0360-3016(02)02709-8
Jian, James Jer-Min, Skye Hongiun Cheng, Stella Yu-Chen Tsai, Kai-Cheng Lawrence Yen, Nei-Min Chu, Kwan-Yee Chan, Tran-Der Tan, et al. “Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy.Int J Radiat Oncol Biol Phys 53, no. 2 (June 1, 2002): 344–52. https://doi.org/10.1016/s0360-3016(02)02709-8.
Jian JJ-M, Cheng SH, Tsai SY-C, Yen K-CL, Chu N-M, Chan K-Y, et al. Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy. Int J Radiat Oncol Biol Phys. 2002 Jun 1;53(2):344–52.
Jian, James Jer-Min, et al. “Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy.Int J Radiat Oncol Biol Phys, vol. 53, no. 2, June 2002, pp. 344–52. Pubmed, doi:10.1016/s0360-3016(02)02709-8.
Jian JJ-M, Cheng SH, Tsai SY-C, Yen K-CL, Chu N-M, Chan K-Y, Tan T-D, Cheng JC-H, Lin Y-C, Leu S-Y, Hsieh C-I, Tsou M-H, Lin C-Y, Huang AT. Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy. Int J Radiat Oncol Biol Phys. 2002 Jun 1;53(2):344–352.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

June 1, 2002

Volume

53

Issue

2

Start / End Page

344 / 352

Location

United States

Related Subject Headings

  • Weight Loss
  • Survival Rate
  • Stomatitis
  • Patient Compliance
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Metastasis
  • Nasopharyngeal Neoplasms
  • Mouth Mucosa
  • Middle Aged