Asian Pacific Journal of Cancer Prevention

Asian Pacific Organization for Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Three Different Induction Regimens for Nasopharyngeal Cancer

  • Kertmen, Neyran (Department of Medical Oncology, Faculty of Medicine, Hacettepe University) ;
  • Aksoy, Sercan (Department of Medical Oncology, Faculty of Medicine, Hacettepe University) ;
  • Cengiz, Mustafa (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Yazici, Gozde (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Keskin, Ozge (Department of Medical Oncology, Faculty of Medicine, Hacettepe University) ;
  • Babacan, Taner (Department of Medical Oncology, Faculty of Medicine, Hacettepe University) ;
  • Sarici, Furkan (Department of Medical Oncology, Faculty of Medicine, Hacettepe University) ;
  • Akin, Serkan (Department of Medical Oncology, Faculty of Medicine, Hacettepe University) ;
  • Altundag, Kadri (Department of Medical Oncology, Faculty of Medicine, Hacettepe University) ;
  • Gullu, H. Ibrahim (Department of Medical Oncology, Faculty of Medicine, Hacettepe University)
  • Published : 2015.02.04

Abstract

Background: The standard treatment of local advanced nasopharyngeal cancer is chemoradiotherapy. There is a lack of data concerning induction therapy. In this study we retrospectively examined patients treated with induction therapy and chemoradiotherapy. Materials and Methods: Locally advanced nasopharyngeal cancer patients treated between 1996 and 2013 in our clinic were included in the study. Three different induction regimens were administered to our patients in different time periods. The regimen dosages were: CF regimen, cisplatin $50mg/m^2$ 1-2 days, fluorouracil $500mg/m^2$ 1-5 days; DC, docetaxel $75mg/m^2$ 1 day, cisplatin $75mg/m^2$ 1 day; and DCF, docetaxel $75mg/m^2$ 1 day, cisplatin $75mg/m^2$ 1 day, 5-Fu $750mg/m^2$ 1-5 days. Most of the patients were stage III (36.4%) and stage IV (51.7%). Results: Median follow-up time was 50 months (2-201 months). Three-year progression-free survival (PFS) was 79.3%, and 5-year PFS 72.4% in all patients. Three-year overall survival (OS) was 87.4% and 5-year OS 76% in all patients. In terms of induction therapies, 3-year OS was 96.5% in the DCF group, 86.6% in the DC group and 76.3% in the CF group (p=0.03). Conclusions: There was no significant differences in response rate and PFS between the three regimens. OS in the DCF group was significantly higher than in the other groups. However, this study was retrospective and limited toxicity data were available; the findings therefore need to be interpreted with care.

Keywords

File

Download PDF

References

  1. Airoldi M, Gabriele AM, Garzaro M, et al (2009). Induction chemotherapy with cisplatin and epirubicin followed by radiotherapy and concurrent cisplatin in locally advanced nasopharyngeal carcinoma observed in a non-endemic population. Radiother Oncol, 92, 105-10. https://doi.org/10.1016/j.radonc.2009.02.005
  2. Airoldi M, Gabriele P, Gabriele AM, et al (2011). Induction chemotherapy with carboplatin and taxol followed by radiotherapy and concurrent weekly carboplatin+taxol in locally advanced nasopharyngeal carcinoma. Cancer Chemother Pharmacol, 67, 1027-34. https://doi.org/10.1007/s00280-010-1399-5
  3. Al-Amro A, Al-Rajhi N, Khafaga Y, et al (2005). Neoadjuvant chemotherapy followed by concurrent chemo-radiation therapy in locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys, 62, 508. https://doi.org/10.1016/j.ijrobp.2004.09.050
  4. Bae WK, Hwang JE, Shim HJ, et al (2010). Phase II study of docetaxel, cisplatin, and 5-FU induction chemotherapy followed by chemoradiotherapy in locoregionally advanced nasopharyngeal cancer. Cancer Chemother Pharmacol, 65, 589-95 https://doi.org/10.1007/s00280-009-1152-0
  5. 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, 64, 47. https://doi.org/10.1016/j.ijrobp.2005.06.037
  6. Bossi P, Orlandi E, Bergamini C, et al (2011). Docetaxel, cisplatin and 5-fluorouracil-based induction chemotherapy followed by intensity-modulated radiotherapy concurrent with cisplatin in locally advanced EBV-related nasopharyngeal cancer. Ann Oncol, 22, 2495-500 https://doi.org/10.1093/annonc/mdq783
  7. Chan AT, Teo PM, Huang DP, et al (2004). Pathogenesis and treatment of nasopharyngeal carcinoma. Semin Oncol, 31, 794. https://doi.org/10.1053/j.seminoncol.2004.09.008
  8. Chua DT, Sham JS, Choy D, et al (1998). Preliminary report of the asian-oceanian clinical oncology association randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. asian-oceanian clinical oncology association nasopharynx cancer study group. Cancer, 83, 2270. https://doi.org/10.1002/(SICI)1097-0142(19981201)83:11<2270::AID-CNCR6>3.0.CO;2-T
  9. Chua DT, Ma J, Sham JS, et al (2005). Long-term survival after cisplatin-based induction chemotherapy and radiotherapy for nasopharyngeal carcinoma, a pooled data analysis of two phase III trials. J Clin Oncol, 23, 1118 https://doi.org/10.1200/JCO.2005.12.081
  10. Eisenhauer EA, Therasse P, Bogaerts J, et al (2009). New response evaluation criteria in solid tumours, revised RECIST guideline (version 1.1). Eur J Cancer, 45, 228. https://doi.org/10.1016/j.ejca.2008.10.026
  11. Ekenel M, Keskin S, Basaran M, et al (2011). Induction chemotherapy with docetaxel and cisplatin is highly effective for locally advanced nasopharyngeal carcinoma. Oral Oncol, 47, 660-4. https://doi.org/10.1016/j.oraloncology.2011.04.010
  12. Fountzilas G, Ciuleanu E, Bobos M, et al (2012). Induction chemotherapy followed by concomitant radiotherapy and weekly cisplatin versus the same concomitant chemoradiotherapy in patients with nasopharyngeal carcinoma, a randomized phase II study conducted by the hellenic cooperative oncology group (HeCOG) with biomarker evaluation. Ann Oncol, 23, 427-435. https://doi.org/10.1093/annonc/mdr116
  13. Hareyama M, Sakata K, Shirato H, et al (2002). A prospective, randomized trial comparing neoadjuvant chemotherapy with radiotherapy alone in patients with advanced nasopharyngeal carcinoma. Cancer, 94, 2217-23. https://doi.org/10.1002/cncr.10473
  14. Hui EP, Ma BB, Chan AT, 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
  15. Jamshed A, Hussain R, Iqbal H (2014). Gemcitabine and cisplatin followed by chemo-radiation for advanced nasopharyngeal carcinoma. Asian Pac J Cancer Prev, 15, 899-904. https://doi.org/10.7314/APJCP.2014.15.2.899
  16. Kong L, Zhang YW, Hu CS, et al (2010). Neoadjuvant chemotherapy followed by concurrent chemoradiation for locally advanced nasopharyngeal carcinoma. Chin J Cancer, 29, 551-5. https://doi.org/10.5732/cjc.009.10518
  17. 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. https://doi.org/10.1200/JCO.2004.10.074
  18. Lee AW, Sze WM, Au JS, et al (2005). Treatment results for nasopharyngeal carcinoma in the modern era, the Hong Kong experience. Int J Radiat Oncol Biol Phys, 61, 1107. https://doi.org/10.1016/j.ijrobp.2004.07.702
  19. Lee AW, Lau KY, Hung WM, et al (2008). Potential improvement of tumor control probability by induction chemotherapy for advanced nasopharyngeal carcinoma. Radiother Oncol, 87, 204-10. https://doi.org/10.1016/j.radonc.2008.02.003
  20. Lee AWM, Ng WT, Chan OSH, et al (2012). If concurrentadjuvant chemoradiotherapy is beneficial for locoregionally advanced nasopharyngeal carcinoma, would changing the sequence to induction-concurrent achieve better outcome? J Radiat Oncol, 1, 107-15. https://doi.org/10.1007/s13566-012-0032-0
  21. Liang ZG, Zhu XD, Tan AH, et al (2013). Induction chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy with or without adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma, meta-analysis of 1,096 patients from 11 randomized controlled trials. Asian Pac J Cancer Prev, 14, 515-21. https://doi.org/10.7314/APJCP.2013.14.1.515
  22. Ma J, Mai HQ, Hong MH, et al (2001). Results of a prospective randomized trial comparing neoadjuvant chemotherapy plus radiotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol, 19, 1350-1357.
  23. Oh JL, Vokes EE, Kies MS, et al (2003). Induction chemotherapy followed by concomitant chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal cancer. Ann Oncol, 14, 564. https://doi.org/10.1093/annonc/mdg163
  24. Phua VCE, Loo WH et al (2013). Treatment outcome for nasopharyngeal carcinoma in University Malaya Medical Centre from 2004-2008. Asian Pac J Cancer Prev, 14, 4567-70 https://doi.org/10.7314/APJCP.2013.14.8.4567
  25. Rischin D, Corry J, Smith J, et al (2002). Excellent disease control and survival in patients with advanced nasopharyngeal cancer treated with chemoradiation. J Clin Oncol, 20, 1845-52. https://doi.org/10.1200/JCO.2002.07.011
  26. 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
  27. Yau TK, Lee AW, Wong DH, et al (2006). Induction chemotherapy with cisplatin and gemcitabine followed by accelerated radiotherapy and concurrent cisplatin in patients with stage IV(A-B) nasopharyngeal carcinoma. Head Neck, 28, 880. https://doi.org/10.1002/hed.20421

Cited by

  1. Selective Radiotherapy after Distant Metastasis of Nasopharyngeal Carcinoma Treated with Dose-Dense Cisplatin plus Fluorouracil vol.16, pp.14, 2015, https://doi.org/10.7314/APJCP.2015.16.14.6011