| High Dose Radiation Therapy Concurrent with Chemotherapy in Locally Advanced Nasopharynx Cancer |
| Min Kyu Kang, Yong Chan Ahn, Won Park, Keunchil Park, Chung Hwan Baek, Young Ik Son, Jeong Eun Lee, Young Je Park, Hee Rim Nam, Kyoung Ju Kim, Do Hoon Lim, Seung Jae Huh |
1Department of Radiation Oncology, Samsung Medical Center,Sungkyunkwan University School of Medicine, Seoul, Korea.ycahn@smc. samsung.co.kr
2Department of Internal Medicine, Samsung Medical Center,Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Otorhinolaryngology-Head and Neck Surgery,Samsung Medical Center, Sungkyunkwan University School ofMedicine, Seoul, Korea.
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Published online: October 31, 2003. |
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| ABSTRACT |
PURPOSE:
Here, our results from a prospective treatment protocol of concurrent radiochemotherapy (CRCT), which was conducted for locally advanced nasopharynx cancers, between April 1994 and May 2001, are reported.
MATERIALS AND METHODS:
A total of 52 consecutive eligible patients were accumulated for this protocol. The median radiation doses to the primary site, involved nodes and uninvolved neck were 72, 61.2 and 45 Gy, using a serial shrinking field technique. The boost techniques were 3-dimensional conformal radiation therapy in 45, intracavitary brachytherapy in 3 and 2-dimensional radiation therapy, with multiple small fields, in 2 patients. Two chemotherapy regimens were used: the first regimen, used in 8 patients during the earlier part of the study duration, consisted of 2 cycles of cisplatin plus 5- fluorouracil every 4 weeks, with concurrent radiation therapy, and 4 cycles with the same agents every 4 weeks, adjuvantly; the second regimen, used in 44 patients during the later part, consisted of 3 cycles of cisplatin every 3 weeks, with concurrent radiation therapy and 3 cycles of adjuvant cisplatin plus 5-fluorouracil every 3 weeks.
RESULTS:
The median follow-up period of the survivors was 32 months. The male to female ratio was 36/16, with a median age of 48 years. The stages, according to the new AJCC staging system (1997), were IIb in 6, III in 23, IVa in 14 and IVb in 9 patients. Fifty and 32 patients completed the planned radiation therapy and concurrent chemotherapy, respectively. Two patients died, 1 of septic shock during the CRCT and the other of malnutrition during the adjuvant chemotherapy. There were 12 failures in 11 patients: 7 locoregional recurrences, 1 within and 6 outside the radiation target volume, and 5 distant metastases. The locoregional control, disease-free survival and overall survival rates were 84.3, 78.8 and 92.8% at 3 years, respectively.
CONCLUSION:
High dose radiation therapy, coupled with concurrent chemotherapy, was judged a highly effective treatment for locally advanced nasopharynx cancers. |
| Key words:
Nasopharynx neoplasm;Radiation therapy;Chemotherapy |
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