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J Korean Soc Ther Radiol Oncol > Volume 17(4); 1999 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 1999;17(4): 275-280.
Neoadjuvant Chemotherapy and Radiation Therapy inAdvanced Stage Nasopharyngeal Carcinoma
Semie Hong, Hong Gyun Wu, Charn II Park
1Department of Therapeutic Radiology, Seoul National University College of Medicine, Korea.
2Institute of Radiation Medicine, Medical Research Center, Seoul National Univerisity, Korea.
ABSTRACT
PURPOSE:
To assess the feasibility and the toxicity of the neoadjuvant chemotherapy on the treatment of patients with locoregionally advanced nasopharyngeal carcinoma.
MATERIALS AND METHODS:
We analyzed 77 previouly untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with neoadjuvant chemotherapy followed by radiation therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows : AJCC stage III-2, stage IV-75, Sixty-six patients received infusion of 5-FU (1000 mg/m2, on Day 1~5) and cisplatin (100 mg/m2, on Day 1), eleven patients received infusion of 5-FU (1000 mg/m2, on Day 1~5) and carboplatin (300 mg/m2, on Day 1), as neoadjuvant chemotherapy prior to radiation therapy. The median follow-up for surviving patients was 44 months.
RESULTS:
The overall chemotherapy response rates were 87%. The toxicities of chemotherapy were mild. Only 3 patients experienced Grade 3 toxicities (1 for cytopenia, 2 for nausea/vomiting). The degree of radiation induced mucositis was not severe, and then patients developed Grade 2 mucositis. The 5-year overall survival rates were 68% and the 5-year disease free survival rates were 65%. The 5-year overall survival rates were 68% and the 5-year disease free survival rates were 65%. The 5-year freedom from distant metastasis rates were 82% and 5-year locoregional control rates were 75%.
CONCLUSION:
This single institution experience suggests that neoadjuvant chemotherapy improves overall survival and disease free survival for patients with advanced stage nasopharyngeal carcinoma without increase of toxicity.
Key Words: Nasopharyngeal carcinoma, Neoadjuvant chemotherapy, Radiation therapy
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