Improved outcome secondary to concurrent chemoradiotherapy for advanced carcinoma of the nasopharynx: Preliminary corroboration of the intergroup experience
Improved outcome secondary to concurrent chemoradiotherapy for advanced carcinoma of the nasopharynx: Preliminary corroboration of the intergroup experience
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DOI：
10.1016/s0360-3016(00)00558-7
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发表时间：
2000-07-01
影响因子：
7
通讯作者：
Hochster, H
中科院分区：
文献类型：
--
作者：
Cooper, JS;Lee, H;Hochster, H
目的：最近的Intergroup 0099试验表明，与单独放疗相比，同步放化疗可提高晚期鼻咽癌的生存率。本研究结束后，我们采用0099中使用的放化疗方案作为我们的标准实践。我们在此报告我们最近的机构结果，代表了一个相对较大的统一治疗队列。方法和材料：1995年至1997年间，连续35例临床非播散性III期或IV期鼻咽癌患者接受放化疗。规定的放射方案是在7周内分35次向所有宏观疾病提供7000 cGy，向被认为存在微观疾病风险的区域提供5000 cGy。化疗设计为在放疗的第1、22和43天给予顺铂（100 mg/m(2)静脉注射），在第71、99和127天给予顺铂（80 mg/m(2)静脉注射），在第71-74、99-102和127-130天给予氟尿嘧啶（5-FU; 1 g/m(2)/天，输注96小时）。结果：所有患者对治疗至少有部分缓解（PR），其中完全缓解（CR）率为85%，精算3年总生存率为93%，无病生存率为65%。两者都代表了我们的机构历史对照单独放射治疗的实质性改进，两者都与组间试验中观察到的比率相似。结论：我们的数据支持这样的结论，即同步放化疗后辅助化疗（如Intergroup 0099中使用的）应该被认为是晚期鼻咽癌患者的当前标准治疗，(C) 2000 Elsevier Science Inc。
Purpose: The recent Intergroup 0099 trial of concurrent chemoradiotherapy for advanced nasopharyngeal carcinomas, demonstrated improved survival for chemoradiotherapy as compared to radiation therapy alone. Following closure of this study, we adopted the chemoradiotherapy regimen used in 0099 as our standard of practice. We herein report our recent institutional results, representing a relatively large uniformly treated cohort.Methods and Materials: Between 1995 and 1997, 35 consecutive patients, who had clinically nondisseminated Stage III or IV nasopharyngeal cancer, were treated by chemoradiotherapy. The prescribed radiation regimen was 7000 cGy delivered in 35 fractions over 7 weeks to all macroscopic disease and 5000 cGy to areas considered at risk of harboring microscopic disease. Chemotherapy was designed to deliver cisplatin (100 mg/m(2) i.v.) on Days 1, 22, and 43 of radiation therapy and cisplatin (80 mg/m(2) i.v.) on Days 71, 99, and 127 plus flurouracil (5-FU; 1 g/m(2)/day by 96-h infusion) on Days 71-74, 99-102, and 127-130.Results: All patients had at least a partial response (PR) to treatment, including an 85% complete response (CR) rate, The actuarial 3-year overall survival rate was 93% and the disease-free survival rate was 65%. Both represent substantial improvements over our institutional historical controls treated by radiation therapy alone and both are similar to the rates observed in the Intergroup trial.Conclusion: Our data support the conclusion that concurrent chemoradiotherapy followed by adjuvant chemotherapy (as was used in Intergroup 0099) should be considered the current standard of care for patients who have advanced cancers of the nasopharynx, (C) 2000 Elsevier Science Inc.