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Therapeutic results of alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil: its usefulness and controversial points.

AbstractBACKGROUND:
The present study was conducted to evaluate the therapeutic results of alternating chemoradiotherapy for locally advanced nasopharyngeal cancer (NPC).
METHODS:
The subjects consisted of six patients with stage III nasopharyngeal cancer and 26 patients with stage IV nasopharyngeal cancer. Using 6 MV photons, radiotherapy was performed at an exposure of 1.8-2.0 Gy five times per week. That is, a total absorbed dose of 36-40 Gy was irradiated between the base of the skull and supraclavicular fossa. After decreasing the irradiation field, an absorbed dose of 26-30 Gy was additionally given thereafter. One course of chemotherapy consisted of the administration of 5-fluorouracil (5-FU) at a dose of 700 mg/m2/24 h for 5 days (days 1-5) and cisplatin (CDDP) at a dose of 50 mg/m2/24 h for 2 days (days 6-7) and a total of 2-3 courses of chemotherapy were performed. During the alternating chemoradiotherapy, chemotherapy was performed initially and 3-5 days after completing the chemotherapy, radiotherapy was performed for 3-4 weeks. Thereafter, chemotherapy and radiotherapy were performed alternately.
RESULTS:
The scheduled courses of alternating chemoradiotherapy were completed in 30 (94%) of 32 patients. Although one patient developed shock induced by metal allergy to CDDP, no severe adverse effects were noted in any other patients. In these 32 patients, the overall 5-year survival rate was 75% (95% confidence interval: 60-90%) and the progression-free survival rate was 63% (95% CI: 46-89%).
CONCLUSIONS:
This method of alternating chemoradiotherapy yielded higher or at least similar survival rates and lower toxicities than concurrent chemoradiotherapy and is worth trying in a multi-institutional study.
AuthorsN Fuwa, Y Ito, T Kodaira, A Matsumoto, M Kamata, K Furutani, H Tatibana, M Sasaoka, K Morita
JournalJapanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 31 Issue 12 Pg. 589-95 (Dec 2001) ISSN: 0368-2811 [Print] England
PMID11902489 (Publication Type: Journal Article)
Chemical References
  • Cisplatin
  • Fluorouracil
Topics
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
  • Cisplatin (administration & dosage)
  • Combined Modality Therapy
  • Drug Administration Schedule
  • Female
  • Fluorouracil (administration & dosage)
  • Humans
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms (drug therapy, mortality, radiotherapy)
  • Radiotherapy Dosage
  • Survival Rate

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