Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy
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Purpose To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngealcarcinoma, we compared the treatment outcomes of patients treated with curative radiotherapywith or without chemotherapy. Materials and MethodsFrom 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitalsin South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvantchemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gyto 74.2 Gy (median, 70 Gy). ResultsMedian follow-up was 48 months (range, 7 to 97 months) for all patients. At the last followup,13 patients had died and 32 had experienced treatment failure; locoregional failureoccurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-freesurvival, distant metastasis-free survival, progression-free survival, and overall survival were86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that thesignificant prognostic factors were concurrent chemotherapy and N stage for locoregionalrelapse-free survival, concurrent chemotherapy for progression-free survival, and age andN stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improveddistant metastasis-free survival. ConclusionConcurrent chemotherapy significantly improved 5-year locoregional relapse-free survivaland progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvantchemotherapy failed to improve either
Abstract
Purpose To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngealcarcinoma, we compared the treatment outcomes of patients treated with curative radiotherapywith or without chemotherapy. Materials and MethodsFrom 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitalsin South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvantchemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gyto 74.2 Gy (median, 70 Gy). ResultsMedian follow-up was 48 months (range, 7 to 97 months) for all patients. At the last followup,13 patients had died and 32 had experienced treatment failure; locoregional failureoccurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-freesurvival, distant metastasis-free survival, progression-free survival, and overall survival were86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that thesignificant prognostic factors were concurrent chemotherapy and N stage for locoregionalrelapse-free survival, concurrent chemotherapy for progression-free survival, and age andN stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improveddistant metastasis-free survival. ConclusionConcurrent chemotherapy significantly improved 5-year locoregional relapse-free survivaland progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvantchemotherapy failed to improve either
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