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Concurrent Weekly Docetaxel Chemotherapy in Combination with Radiotherapy for Stage III and IVA-B Nasopharyngeal Carcinoma

  • Wei, Wei-Hong (Department of Radiation Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University) ;
  • Cai, Xiu-Yu (Department of Medical Oncology, State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University) ;
  • Xu, Tao (Department of Radiation Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University) ;
  • Zhang, Guo-Yi (Department of Radiation Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University) ;
  • Wu, Yong-Feng (Department of Radiation Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University) ;
  • Feng, Wei-Neng (Department of Medical Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University) ;
  • Lin, Li (Department of Radiation Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University) ;
  • Deng, Yan-Ming (Department of Medical Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University) ;
  • Lu, Qiu-Xia (Department of Radiation Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University) ;
  • Huang, Zhe-Li (Department of Radiation Oncology, First People's Hospital of Foshan Affiliated to Sun Yat-sen University)
  • Published : 2012.03.31

Abstract

Background and Purpose: Cisplatin is the most common chemotherapeutic agent for loco-regionally advanced nasopharyngeal carcinoma (NPC); however, toxicity is a limiting factor for some patients. We retrospectively compared the efficacy and toxicity of weekly docetaxel-based and cisplatin-based concurrent chemoradiotherapy in loco-regionally advanced NPC. Methods and Materials: Eighty-four patients with Stage III and IVA-B NPCs, treated between 2007 and 2008, were retrospectively analyzed. Thirty received weekly docetaxel-based concurrent chemotherapy, and 43 were given weekly cisplatin-based concurrent chemotherapy. Radiotherapy was administered using a conventional technique (seven weeks, 2.0 Gy per fraction, total dose 70-74 Gy) with 6-8 Gy boosts for some patients with locally advanced disease. Results: Median follow-up time was 42.3 months (range, 8.6-50.8 months). There were no significant differences in the 3-year loco-regional failure-free survival (85.6% vs. 92.3%; p=0.264), distant failure-free survival (87.0% vs. 92.5%; p=0.171), progression-free survival (85.7% vs. 88.4%; p=0.411) or overall survival (86.5% vs. 92.5%, p=0.298) of patients treated concurrently with docetaxel or cisplatin. Severe toxicity was not common in either group. Conclusions: Weekly docetaxel-based concurrent chemoradiotherapy is potentially effective and has a tolerable toxicity; however, further investigations are required to determine if docetaxel is superior to cisplatin for advanced stage NPC.

References

  1. Al-Sarraf M, LeBlanc M, Giri PG, et al (1998). Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol, 16, 1310-7. https://doi.org/10.1200/JCO.1998.16.4.1310
  2. Baujat B, Audry H, Bourhis J, et al (2006). Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys, 1, 47-56.
  3. Biete Solà A, Marruecos Querol J, Calvo Manuel FA, et al (2007). Phase II trial, concurrent radio-chemotherapy with weekly docetaxel for advanced squamous cell carcinoma of head and neck. Clin Transl Oncol, 9, 244-50. https://doi.org/10.1007/s12094-007-0047-y
  4. Chan AT, Leung SF, Ngan RK, et al (2005). Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst, 97, 536-9. https://doi.org/10.1093/jnci/dji084
  5. Cao SM, Simons MJ, Qian CN (2011). The prevalence and prevention of nasopharyngeal carcinoma in China. Chin J Cancer, 30,114-9. https://doi.org/10.5732/cjc.010.10377
  6. Calais G, Bardet E, Sire C, et al (2004). Radiotherapy with concomitant weekly docetaxel for Stages III/IV oropharynx carcinoma. Results of the 98-02 GORTEC Phase II trial. Int J Radiat Oncol Biol Phys, 58, 161-6. https://doi.org/10.1016/S0360-3016(03)01370-1
  7. Chen M, Wu SX, Chen YY, et al (2004). Radiation therapy concurrent with weekly paclitaxel for locoregionally advanced nasopharyngeal carcinoma: outcomes of a phase I trial. Am J Clin Oncol, 27, 481-4. https://doi.org/10.1097/01.coc.0000135180.94470.45
  8. Chen CY, Lu TX, Zhao C, et al (2007). Weekly paclitaxel with concurrent intensity-modulated radiotherapy for nasopharyngeal carcinoma: outcomes of a tolerance trial. Ai Zheng, 26, 398-402.
  9. Fukada J, Shigematsu N, Takeda A, et al (2010). Weekly low-dose docetaxel-based chemoradiotherapy for locally advanced oropharyngeal or hypopharyngeal carcinoma: a retrospective, single-institution study. Int J Radiat Oncol Biol Phys, 76, 417-24. https://doi.org/10.1016/j.ijrobp.2009.01.056
  10. Hui EP, Ma BB, Leung SF, et al (2009). Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma. J Clin Oncol, 27, 242-9. https://doi.org/10.1200/JCO.2008.18.1545
  11. Hu W, Ding W, Yang H, et al (2009). Weekly paclitaxel with concurrent radiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma. Radiother Oncol, 93, 488-91. https://doi.org/10.1016/j.radonc.2009.06.030
  12. Lin JC, Jan JS, Hsu CY, et al (2003). Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol, 21, 631-7. https://doi.org/10.1200/JCO.2003.06.158
  13. Langendijk JA, Leemans CR, Buter J, et al (2004). The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma: a meta-analysis of the published literature. J Clin Oncol, 22, 4604-12. https://doi.org/10.1200/JCO.2004.10.074
  14. Lee AW, Lau WH, Tung SY, et al (2005). Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol, 23, 6966-75. https://doi.org/10.1200/JCO.2004.00.7542
  15. Lai SZ, Li WF, Chen L, et al (2011). How does intensitymodulated radiotherapy versus conventional twodimensional radiotherapy influence the treatment results in nasopharyngeal carcinoma patients? Int J Radiat Oncol Biol Phys, 80, 661-8. https://doi.org/10.1016/j.ijrobp.2010.03.024
  16. Posner MR, Hershock DM, Blajman CR, et al (2007). Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med, 357, 1705-15. https://doi.org/10.1056/NEJMoa070956
  17. Tishler RB, Geard CR, Hall EJ, et al (1992). Taxol sensitizes human astrocytoma cells to radiation. Cancer Res, 52, 3495-7.
  18. Tishler RB, Schiff PB, Geard CR, et al (1992). Taxol: a novel radiation sensitizer. Int J Radiat Oncol Biol Phys, 22, 613-7. https://doi.org/10.1016/0360-3016(92)90888-O
  19. Tishler RB, Norris CM, Colevas AD, et al (2002). A phase I/II trial of concurrent docetaxel and radiation after induction chemotherapy in patients with poor prognosis squamous cell carcinoma of the head and neck. Cancer, 95, 1472-81. https://doi.org/10.1002/cncr.10873
  20. Tishler RB, Posner MR, Norris CM Jr, et al (2006). Concurrent weekly docetaxel and concomitant boost radiation therapy in the treatment of locally advanced squamous cell cancer of the head and neck. Int J Radiat Oncol Biol Phys, 65, 1036-44. https://doi.org/10.1016/j.ijrobp.2006.02.010
  21. Vermorken JB, Remenar E, van Herpen C, et al (2007). Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med, 357, 1695-704. https://doi.org/10.1056/NEJMoa071028
  22. Wahl AF, Donaldson KL, Fairchild C, et al (1996). Loss of normal p53 function confers sensitization to Taxol by increasing G2/M arrest and apoptosis. Nat Med, 2, 72-9. https://doi.org/10.1038/nm0196-72
  23. Wee J, Tan EH, Tai BC, et al (2005). Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol, 23, 6730-8. https://doi.org/10.1200/JCO.2005.16.790

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