Comparison of concurrent chemoradiotherapy versus induction chemotherapy followed by radiation in patients with nasopharyngeal carcinoma

Department of Otolaryngology, and Head and Neck Surgery, Yokohama City University School of Medicine, 9-3 Fukuura, Kanazawa-Ku, Yokohama 236-0004, Japan.
Anticancer research (Impact Factor: 1.83). 02/2012; 32(2):681-6.
Source: PubMed


The study aimed to evaluate the efficacy of concurrent chemoradiotherapy (CCRT) with platinum-based chemotherapy as a primary treatment for nasopharyngeal carcinoma (NPC) and to further compare the results of CCRT with these of neoadjuvant chemotherapy (NAC) followed by radiotherapy (RT).
Before 1998, 21 patients with NPC received NAC followed by RT (NAC-RT). Between 1999 and 2008, a total of 25 NPC patients received CCRT. The CCRT group received a regimen including docetaxel (50 mg/m(2), day1), cisplatin (CDDP, 60 mg/m(2), day4) and continuous 5-fluorouracil (5-FU) infusion (600 mg/m(2), day 1-5), the TPF regimen, or a regimen including CDDP (60 mg/m(2), day4), continuous 5-FU infusion (600 mg/m(2), day 1-5), methotrexate (MTX, 30 mg/m(2), day 1) and leucovorin (LV, 20 mg/m(2), day 1-5), PFML regimen. The CCRT group received 2 cycles of chemotherapy during definitive RT. The NAC group of patients received a PFML regimen.
The overall response rate after CCRT was 96%. The 3-year and 5-year disease-specific survival rates were 75.6% and 60.1%, respectively. In patients receiving NAC-RT, the 3-year and 5-year disease-specific survival rates were 84.1% and 67.3%, respectively. There was no difference observed in terms of survival rates between the group receiving CCRT and that receiving NAC-RT.
CCRT with the TPF or PFML regimen was tolerable, and the NPC patients receiving this treatment showed excellent survival rates. In comparison to the group receiving NAC-RT, CCRT had no advantage in terms of the survival rate. In the future, the control of distant metastasis might play an important role in improving the survival rate of patients with advanced NPC receiving CCRT.

1 Follower
20 Reads
  • Source
    • "Currently, the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology recommend concurrent chemoradiotherapy for the treatment of locally advanced NPC (7,8,9). Studies of targeted therapies have been encouraging in recent years. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In China, the incidence of nasopharyngeal carcinoma (NPC) and tuberculosis remains high. Additionally, there has been a marked increase in the prevalence of gout. In recent years, there has been an increase in the number of coexisting diseases. To the best of our knowledge, there have been no previous cases reported in the literature with regard to patients suffering from NPC complicated with pulmonary tuberculosis and gout. The present study describes the case of a 59yearold male with this condition. The patient received a combination of antitumor, antituberculosis and antigout therapies, and experienced no severe adverse reactions during treatment. At present, the patient's Eastern Cooperative Oncology Group performance status is good, there has been no local recurrence or distant metastasis of the NPC, and the pulmonary tuberculosis and gout are well controlled. The aim of this study was to provide insight into the treatment of patients suffering from coexisting conditions.
    Oncology letters 05/2014; 8(2). DOI:10.3892/ol.2014.2180 · 1.55 Impact Factor
  • Source
    • "Therapeutic strategies have been studied aiming to improve the survival rate for advanced NPC. Recently, novel therapies based on molecular targets and neoadjuvant chemotherapy (NAC) followed by RT of NPC were promising for advanced lesions [7,8], though need to be validated in more trials. Conventional TNM staging has a strong prognostic implication for NPC [9]; and patients at early-stage are almost curable under RT, however, the prognosis remains poor in a significant number of patients with late-stage NPC [10] . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Heat shock protein 70, a stress protein, has been implicated in tumor progression. However, its role in nasopharyngeal carcinoma (NPC) progression has not yet been clearly investigated. Immunohistochemistry (IHC) was employed to examine the expression patterns of Hsp70, human leukocyte antigen -A (HLA-A) in NPC tissue samples. The expression of Hsp70 exhibited different spatial patterns among nuclear, membrane and cytoplasm in 507 NPC tumor tissues. Kaplan-Meier survival analysis demonstrated that different Hsp70 expression patterns are correlated with different patient outcomes. High membranal and cytoplasmic levels of Hsp70 predicted good survival of patients. In contrast, high nuclear abundance of Hsp70 correlated with poor survival. Moreover, the membranal and cytoplasmic levels of Hsp70 were positively correlated with levels of the MHC I molecule HLA-A. Different Hsp70 expression patterns had distinct predictive values. The different spatial abundance of Hsp70 may imply its important role in NPC development and provide insight for the development of novel therapeutic strategies involving immunotherapy for NPC.
    Journal of Translational Medicine 05/2012; 10(1):96. DOI:10.1186/1479-5876-10-96 · 3.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Nasopharyngeal carcinoma (NPC) often develops drug resistance following radiotherapy. The molecular basis of radiotherapy-related multidrug resistance (MDR) remains unclear. In the present study, we investigated the effect of fractionated irradiation on the expression of the MDR-1 gene and the MDR-associated protein P-glycoprotein (P-gp) in CNE1 human NPC cells. CNE1 cells were treated with fractionated X-rays. Drug resistance was determined by MTT assay. The expression levels of MDR-1 and P-gp were analyzed by RT-PCR and western blot analysis, respectively. Differential expression was analyzed by gene chips. The results revealed that low levels of mRNA expression of MDR1 were present in non-irradiated CNE1 cells. Compared with the control, the expression of MDR1 mRNA was gradually increased following fractionated irradiation. On day 21, the expression of MDR1 mRNA was increased 1.59- and 2.19-fold, compared with the control, by treatment with 10 and 20 Gy, respectively. We observed decreased MDR1 expression following treatment with 10 and 20 Gy irradiation on days 28 and 35, compared with day 21. On days 21, 28 and 35, expression was increased 1.37-, 1.40- and 1.15-fold by treatment with 20 Gy compared with 10 Gy. Expression of MDR1 was significantly upregulated by treatment with 50 Gy irradiation compared with the control on days 78 and 106. P-gp expression was consistent with that of MDR1 mRNA expression. The sensitivity of CNE1 cells to cisplatin was reduced following irradiation compared with the control. A total of 26 genes were significantly upregulated and 8 genes were significantly downregulated compared with the control. Results of the present study have shown that MDR1 and P-gp are upregulated in CNE1 cells following irradiation. Multiple genes were involved in the mechanism of radiation-induced drug resistance.
    Molecular Medicine Reports 10/2012; 7(1). DOI:10.3892/mmr.2012.1148 · 1.55 Impact Factor
Show more

Similar Publications