DOI QR코드

DOI QR Code

Progress and Challenges in Chemotherapy for Loco-Regionally Advanced Nasopharyngeal Carcinoma

  • Liang, Zhong-Guo (Department of Radiation Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region) ;
  • Chen, Ze-Tan (Department of Radiation Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region) ;
  • Li, Ling (Department of Radiation Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region) ;
  • Qu, Song (Department of Radiation Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region) ;
  • Zhu, Xiao-Dong (Department of Radiation Oncology, the Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region)
  • Published : 2015.07.13

Abstract

Incidence rates of nasopharyngeal carcinoma are high in Indonesia, Singapore and South-Eastern China. Chemoradiotherapy has been the standard regimen for locally advanced nasopharyngeal carcinoma according to guidelines from the National Comprehensive Cancer Network. Recently, advances in the management of nasopharyngeal carcinoma have transferred into better treatment outcomes. Most phase III clinical trials support the addition of concurrent chemotherapy to radiotherapy for the initial treatment of these patients. Studies evaluating effects and toxicity of concurrent chemotherapy with different regimens have been reported. However, the status of adding adjuvant chemotherapy or induction chemotherapy remains controversial. Recent studies have shown that adjuvant chemotherapy with two or three cycles may improve survival for nasopharyngeal carcinoma with stage N2-3 disease or with persistently detectable plasma EBV DNA after radiotherapy. This review examines the pertinent issues and latest studies concerning the management of loco-regionally advanced NPC, regarding concurrent chemotherapy, adjuvant chemotherapy, and induction chemotherapy in decades.

Keywords

References

  1. Airoldi M, Pedani F, Marchionatti S, et al (2002). Carboplatin plus taxol is an effective third-line regimen in recurrent undifferentiated nasopharyngeal carcinoma. Tumori, 88, 273-6.
  2. 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
  3. Baujat B, Audry H, Bourhis J, et al (2009). Chemotherapy as an adjunct to radiotherapy in locally advanced nasopharyngeal carcinoma. Cochrane DB Syst Rev, [Epub ahead of print].
  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. Chan ATC, Ngan RKC, Hui EP, et al (2012). A multicenter randomized controlled trial (RCT) of adjuvant chemotherapy (CT) in nasopharyngeal carcinoma (NPC) with residual plasma EBV DNA (EBV DNA) following primary radiotherapy (RT) or chemoradiotherapy (CRT). J Clin Oncol, 30, 1. https://doi.org/10.1200/JCO.2011.38.2747
  6. Chan ATC, Teo PML, Leung TWT, et al (1995). A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys, 33, 569-77. https://doi.org/10.1016/0360-3016(95)00218-N
  7. Chen L, Hu CS, Chen XZ, et al (2012). Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 3 multicentre randomised controlled trial. Lancet Oncol, 13, 163-71. https://doi.org/10.1016/S1470-2045(11)70320-5
  8. Chen X, Hong Y, Feng J, et al (2014). Concurrent chemoradiotherapy comparison of taxanes and platinum versus 5-fluorouracil and platinum in nasopharyngeal carcinoma treatment. Chin Med J (Engl), 127, 142-9.
  9. Chen Y, Sun Y, Liang SB, et al (2013). Progress report of a randomized trial comparing long-term survival and late toxicity of concurrent chemoradiotherapy with adjuvant chemotherapy versus radiotherapy alone in patients with stage III to IVB nasopharyngeal carcinoma from endemic regions of China. Cancer, 119, 2230-8. https://doi.org/10.1002/cncr.28049
  10. Chi KH, Chang YC, Guo WY, et al (2002). A phase III study of adjuvant chemotherapy in advanced nasopharyngeal carcinoma patients. Int J Radiat Oncol Biol Phys, 52, 1238-44. https://doi.org/10.1016/S0360-3016(01)02781-X
  11. Chitapanarux I, Lorvidhaya V, Kamnerdsupaphon P, et al (2007). Chemoradiation comparing cisplatin versus carboplatin in locally advanced nasopharyngeal cancer: randomised, non-inferiority, open trial. Eur J Cancer, 43, 1399-406. https://doi.org/10.1016/j.ejca.2007.03.022
  12. Chua D, Wei WI, Sham JS, et al (2008). Capecitabine monotherapy for recurrent and metastatic nasopharyngeal cancer. Jpn J Clin Oncol, 38, 244-9. https://doi.org/10.1093/jjco/hyn022
  13. Chua DTT, Ma J, Sham JST, 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, 1118-24. https://doi.org/10.1200/JCO.2005.12.081
  14. Chua DTT, Sham JST, 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. Cancer, 83, 2270-83. https://doi.org/10.1002/(SICI)1097-0142(19981201)83:11<2270::AID-CNCR6>3.0.CO;2-T
  15. Cvitkovic E, Eschwege F, Rahal M, et al (1996). Preliminary results of a randomized trial comparing neoadjuvant chemotherapy (cisplatin, epirubicin, bleomycin) plus radiotherapy vs. Radiotherapy alone in stage IV ((less-than or equal to)N2, M0) undifferentiated nasopharyngeal carcinoma: A positive effect on progression-free survival. Int J Radiat Oncol Biol Phys, 35, 463-9.
  16. Fong KW, Chua EJ, Chua ET, et al (1996). Patient profile and survival in 270 computer tomography-staged patients with nasopharyngeal cancer treated at the Singapore General Hospital. Ann Acad Med Singapore, 25, 341-6.
  17. 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, 427-35. https://doi.org/10.1093/annonc/mdr116
  18. Hareyama M, Sakata KI, 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
  19. He X, Ou D, Ying H, et al (2012). Experience with combination of cisplatin plus gemcitabine chemotherapy and intensity-modulated radiotherapy for locoregionally advanced nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol, 269, 1027-33. https://doi.org/10.1007/s00405-011-1669-9
  20. Heng DM, Wee J, Fong KW, et al (1999). Prognostic factors in 677 patients in Singapore with nondisseminated nasopharyngeal carcinoma. Cancer, 86, 1912-20. https://doi.org/10.1002/(SICI)1097-0142(19991115)86:10<1912::AID-CNCR6>3.0.CO;2-S
  21. 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
  22. Jacobs C, Lyman G, Velez-Garcia E, et al (1992). A phase III randomized study comparing cisplatin and fluorouracil as single agents and in combination for advanced squamous cell carcinoma of the head and neck. J Clin Oncol, 10, 257-63. https://doi.org/10.1200/JCO.1992.10.2.257
  23. Jagdis A, Laskin J, Hao D, et al (2014). Dose delivery analysis of weekly versus 3-weekly cisplatin concurrent with radiation therapy for locally advanced nasopharyngeal carcinoma (NPC). Am J Clin Oncol, 37, 63-9. https://doi.org/10.1097/COC.0b013e31826b9b1a
  24. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  25. K.Thephamongkhol, J.Zhou, Browman, et al (2004). Chemo-radiotherapy versus radiotherapy alone for nasopharyngeal carcinoma: A meta-analysis of 78 randomized controlled trials (RCTs) from English and non-English databases [abstract 5522]. J Clin Oncol, 22, 5493.
  26. Kwong DL, Sham JS, Au GK, et al (2004). Concurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: a factorial study. J Clin Oncol, 22, 2643-53. https://doi.org/10.1200/JCO.2004.05.173
  27. Kwong DLW, Sham JST, and Au GKH (2006). Five-year update on a randomized factorial study on concurrent and adjuvant chemotherapy for advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys, 2006, 15-16.
  28. 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
  29. Lee AWM, 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
  30. Lee AWM, Tung SY, Ngan RKC, et al (2011). Factors contributing to the efficacy of concurrent-adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: Combined analyses of NPC-9901 and NPC-9902 Trials. Eur J Cancer, 47, 656-66. https://doi.org/10.1016/j.ejca.2010.10.026
  31. Liang Z, Zhu X, Li L, et al (2014). Concurrent chemoradiotherapy followed by adjuvant chemotherapy compared with concurrent chemoradiotherapy alone for the treatment of locally advanced nasopharyngeal carcinoma: a retrospective controlled study. Curr Oncol, 21, 408-17. https://doi.org/10.3747/co.21.1777
  32. 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
  33. Lin CC, Chen TT, Lin CY, et al (2013). Prognostic analysis of adjuvant chemotherapy in patients with nasopharyngeal carcinoma. Future Oncol, 9, 1469-76. https://doi.org/10.2217/fon.13.100
  34. 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
  35. 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, 1350-7. https://doi.org/10.1200/JCO.2001.19.5.1350
  36. Maeng CH, Park S, Jung HA, et al (2012). Comparison of clinical outcomes between concurrent chemoradiotherapy followed by adjuvant chemotherapy and concurrent chemoradiotherapy alone for patients associated with locally advanced nasopharyngeal carcinoma: A retrospective analysis of single center experience. J Clin Oncol, 30.
  37. OuYang PY, Xie C, Mao YP, et al (2013). Significant efficacies of neoadjuvant and adjuvant chemotherapy for nasopharyngeal carcinoma by meta-analysis of published literature-based randomized, controlled trials. Ann Oncol, 24, 2136-46. https://doi.org/10.1093/annonc/mdt146
  38. 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
  39. Rossi A, Molinari R, Boracchi P, et al (1988). Adjuvant chemotherapy with vincristine, cyclophosphamide, and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: results of a 4-year multicenter randomized study. J Clin Oncol, 6, 1401-10. https://doi.org/10.1200/JCO.1988.6.9.1401
  40. Ruste SA, Dizon DS, Ramirez F, et al (2011). Induction chemotherapy followed by concurrent chemoradiotherapy vs concurrent chemoradiotherapy followed by chemotherapy in the treatment of patients with advanced nasopharyngeal carcinoma. Phill J Intern Med, 49, 1-7.
  41. 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
  42. Xu J, He X, Cheng K, et al (2014). Concurrent chemoradiotherapy with nedaplatin plus paclitaxel or fluorouracil for locoregionally advanced nasopharyngeal carcinoma: Survival and toxicity. Head Neck, 36, 1474-80.
  43. Xu TT, Hu CS, Wang XS, et al (2011). Comparing treatment outcomes of different chemotherapy sequences during radio-chemotherapy for stage N3 nasopharyngeal carcinoma. Chin J Radiat Oncol, 20, 181-5.
  44. 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, 880-7. https://doi.org/10.1002/hed.20421
  45. Yi JL, Gao L, Huang XD, et al (2006). Nasopharyngeal carcinoma treated by radical radiotherapy alone: Ten-year experience of a single institution. Int J Radiat Oncol Biol Phys, 65, 161-8. https://doi.org/10.1016/j.ijrobp.2005.12.003
  46. Zhang L, Zhao C, Ghimire B, et al (2010). The role of concurrent chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma among endemic population: a meta-analysis of the phase III randomized trials. BMC Cancer, 10, 558. https://doi.org/10.1186/1471-2407-10-558
  47. Zhang L, Zhao C, Peng PJ, et al (2005). Phase III study comparing standard radiotherapy with or without weekly oxaliplatin in treatment of locoregionally advanced nasopharyngeal carcinoma: preliminary results. J Clin Oncol, 23, 8461-8. https://doi.org/10.1200/JCO.2004.00.3863