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Article

Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer

  • Authors:
    • Ting-Yong Fan
    • Jun Xing
    • Jie Lu
    • Tong-Hai Liu
    • Min Xu
    • Ying‑Jie  Zhang
    • Qian Shao
    • Jian-Bin Li
    • Jin-Ming Yu
  • View Affiliations / Copyright

    Affiliations: School of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China, Shandong Cancer Hospital and Institute, Jinan, Shandong 240117, P.R. China
  • Pages: 889-895
    |
    Published online on: January 15, 2013
       https://doi.org/10.3892/ol.2013.1137
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Abstract

This study aimed to evaluate the efficacy, toxicity and tolerability of simultaneous modulated accelerated radiation therapy (SMART)-intensity modulated radiotherapy (IMRT) plus cisplatin and 5-fluorouracil (5-FU) chemotherapy for patients with advanced nasopharyngeal cancer (NPC). Forty-five patients with stage II-IV NPC, determined by the American Joint Committee on Cancer system, were treated with prescribed doses of 72 Gy total to the gross tumor volume, 60 Gy to the clinical target volume and metastatic nodal station, and 54 Gy to the clinically-negative neck region. Before radiotherapy, two cycles of cisplatin (30 mg/m2/day on days 1-3) plus 5-FU (400 mg/m2/day on days 1-5) were delivered every three weeks for two cycles. Patients received two cycles of cisplatin (30 mg/m2 day on days 1-3) every three weeks during radiotherapy. In addition, two cycles of cisplatin and 5-FU were given after radiation. All patients completed the prescribed radiotherapy and all scheduled cycles of chemotherapy. Thirty of the 45 patients (66.6%) had a complete response at the end of treatment. Grade 3 mucositis occurred in 4/45 patients (8.8%) and grade 3 dermatitis occurred in 5/45 (11.1%) during radiotherapy. Grade 3 neutropenia occurred in 6/45 (13.3%) during concurrent chemotherapy. There was no treatment-related mortality. After a median follow-up time of 51 months, only three patients' treatments had failed. Local and distant failure rates were 1.5 and 3.0%, respectively. SMART-IMRT plus cisplatin and 5-FU chemotherapy showed promising activity with manageable toxicity. It is a feasible regimen and improves locoregional disease control.
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1 

Ensley JF, Youssef E, Kim H and Yoo G: Locally advanced nasopharyngeal cancer. Curr Treat Options Oncol. 2:15–23. 2001. View Article : Google Scholar

2 

Chan AT, Teo PM and Johnson PJ: Nasopharyngeal carcinoma. Ann Oncol. 13:1007–1015. 2002. View Article : Google Scholar : PubMed/NCBI

3 

Gius D and Coleman CN: Treatment of nasopharyngeal cancer: raising the ‘Barr’. J Natl Cancer Inst. 94:1594–1595. 2002.

4 

Siegel R, Naishadham D and Jemal A: Cancer statistics, 2012. CA Cancer J Clin. 62:10–29. 2012. View Article : Google Scholar

5 

Wee J: Nasopharyngeal cancer: a promising future. Lancet Oncol. 13:116–118. 2012. View Article : Google Scholar : PubMed/NCBI

6 

Kwong DL, Sham JS, Au GK, et al: Concurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: a factorial study. J Clin Oncol. 22:2643–2653. 2004. View Article : Google Scholar : PubMed/NCBI

7 

Kam MK, Leung SF, Zee B, et al: Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. J Clin Oncol. 25:4873–4879. 2007. View Article : Google Scholar

8 

Wee J, Tan EH, Tai BC, et al: 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. 23:6730–6738. 2005. View Article : Google Scholar

9 

Al-Sarraf M, LeBlanc M, Giri PG, et al: Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 16:1310–1317. 1998.PubMed/NCBI

10 

Chan AT, Leung SF, Ngan RK, et al: Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst. 97:536–539. 2005. View Article : Google Scholar

11 

Zhang L, Zhao C, Peng PJ, et al: Phase III study comparing standard radiotherapy with or without weekly oxaliplatin in treatment of locoregionally advanced nasopharyngeal carcinoma: preliminary results. J Clin Oncol. 23:8461–8468. 2005. View Article : Google Scholar

12 

Lin JC, Jan JS, Hsu CY, Liang WM, Jiang RS and Wang WY: Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol. 21:631–637. 2003. View Article : Google Scholar

13 

Chan AT, Teo PM, Ngan RK, et al: Concurrent chemotherapyradiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial. J Clin Oncol. 20:2038–2044. 2002. View Article : Google Scholar

14 

Lee NY, Zhang Q, Pfister DG, et al: Addition of bevacizumab to standard chemoradiation for locoregionally advanced nasopharyngeal carcinoma (RTOG 0615): a phase 2 multi-institutional trial. Lancet Oncol. 13:172–180. 2012. View Article : Google Scholar : PubMed/NCBI

15 

Al-Amro A, Al-Rajhi N, Khafaga Y, et al: Neoadjuvant chemotherapy followed by concurrent chemoradiation therapy in locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 62:508–513. 2005. View Article : Google Scholar : PubMed/NCBI

16 

Langendijk JA, Leemans CR, Buter J, Berkhof J and Slotman BJ: The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma: a meta-analysis of the published literature. J Clin Oncol. 22:4604–4612. 2004. View Article : Google Scholar : PubMed/NCBI

17 

Lee N, Harris J, Garden AS, et al: Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase II trial 0225. J Clin Oncol. 27:3684–3690. 2009. View Article : Google Scholar

18 

Koom WS, Kim TH, Shin KH, et al: SMART (simultaneous modulated accelerated radiotherapy) for locally advanced nasopharyngeal carcinomas. Head & neck. 30:159–169. 2008.PubMed/NCBI

19 

Lee SW, Back GM, Yi BY, et al: Preliminary results of a phase I/II study of simultaneous modulated accelerated radiotherapy for nondisseminated nasopharyngeal carcinoma. Int J Cancer. 65:152–160. 2006.PubMed/NCBI

20 

Chan AT: Head and neck cancer: treatment of nasopharyngeal cancer. Ann Oncol. 16(Suppl 2): ii265–268. 2005.PubMed/NCBI

21 

Licitra L, Bossi P, Locati L and Zunino F: Cisplatin and fluorouracil concurrent to radiotherapy in nasopharyngeal cancer: is the schedule compatible? J Clin Oncol. 22:377author reply 377–378, 2004.

22 

Chua DT, Ma J, Sham JS, et al: 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. 23:1118–1124. 2005. View Article : Google Scholar : PubMed/NCBI

23 

Hui EP, Ma BB, Leung SF, et al: Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma. J Clin Oncol. 27:242–249. 2009. View Article : Google Scholar

24 

Hong RL, Ting LL, Ko JY, et al: Induction chemotherapy with mitomycin, epirubicin, cisplatin, fluorouracil, and leucovorin followed by radiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol. 19:4305–4313. 2001.

25 

Chan AT, Ma BB, Lo YM, et al: Phase II study of neoadjuvant carboplatin and paclitaxel followed by radiotherapy and concurrent cisplatin in patients with locoregionally advanced nasopharyngeal carcinoma: therapeutic monitoring with plasma Epstein-Barr virus DNA. J Clin Oncol. 22:3053–3060. 2004. View Article : Google Scholar

26 

Cheng SH, Tsai SY, Yen KL, et al: Concomitant radiotherapy and chemotherapy for early-stage nasopharyngeal carcinoma. J Clin Oncol. 18:2040–2045. 2000.PubMed/NCBI

27 

Lee TF, Chao PJ, Ting HM, et al: Comparative analysis of SmartArc-based dual arc volumetric-modulated arc radio-therapy (VMAT) versus intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma. J Appl Clin Med Phys. 12:35872011.PubMed/NCBI

28 

Cheng JC, Chao KS and Low D: Comparison of intensity modulated radiation therapy (IMRT) treatment techniques for nasopharyngeal carcinoma. Int J Cancer. 96:126–131. 2001. View Article : Google Scholar : PubMed/NCBI

29 

Kristensen CA, Kjaer-Kristoffersen F, Sapru W, Berthelsen AK, Loft A and Specht L: Nasopharyngeal carcinoma. Treatment planning with IMRT and 3D conformal radiotherapy. Acta Oncologica. 46:214–220. 2007. View Article : Google Scholar : PubMed/NCBI

30 

Lee N, Xia P, Quivey JM, et al: Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys. 53:12–22. 2002. View Article : Google Scholar : PubMed/NCBI

31 

Lauve A, Morris M, Schmidt-Ullrich R, et al: Simultaneous integrated boost intensity-modulated radiotherapy for locally advanced head-and-neck squamous cell carcinomas: II--clinical results. Int J Radiat Oncol Biol Phys. 60:374–387. 2004. View Article : Google Scholar : PubMed/NCBI

32 

Xiao WW, Huang SM, Han F, et al: Local control, survival, and late toxicities of locally advanced nasopharyngeal carcinoma treated by simultaneous modulated accelerated radiotherapy combined with cisplatin concurrent chemotherapy: long-term results of a phase 2 study. Cancer. 117:1874–1883. 2011. View Article : Google Scholar

33 

Lee VH, Ng SC, Leung TW, Au GK and Kwong DL: Dosimetric predictors of radiation-induced acute nausea and vomiting in IMRT for nasopharyngeal cancer. Int J Cancer. 2012.PubMed/NCBI

34 

Park SH, Park HC, Park SW, et al: Multi-institutional comparison of intensity modulated radiation therapy (IMRT) planning strategies and planning results for nasopharyngeal cancer. J Korean Med Sci. 24:248–255. 2009. View Article : Google Scholar : PubMed/NCBI

35 

Chen QY, Wen YF, Guo L, et al: Concurrent chemoradiotherapy vs radiotherapy alone in stage II nasopharyngeal carcinoma: phase III randomized trial. J Natl Cancer Inst. 103:1761–1770. 2011. View Article : Google Scholar : PubMed/NCBI

36 

Chen L, Hu CS, Chen XZ, et al: 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. 13:163–171. 2012. View Article : Google Scholar

37 

Lee AW, Tung SY, Chua DT, et al: Randomized trial of radiotherapy plus concurrent-adjuvant chemotherapy vs radiotherapy alone for regionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst. 102:1188–1198. 2010. View Article : Google Scholar : PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Fan T, Xing J, Lu J, Liu T, Xu M, Zhang YJ, Shao Q, Li J and Yu J: Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer. Oncol Lett 5: 889-895, 2013.
APA
Fan, T., Xing, J., Lu, J., Liu, T., Xu, M., Zhang, Y. ... Yu, J. (2013). Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer. Oncology Letters, 5, 889-895. https://doi.org/10.3892/ol.2013.1137
MLA
Fan, T., Xing, J., Lu, J., Liu, T., Xu, M., Zhang, Y., Shao, Q., Li, J., Yu, J."Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer". Oncology Letters 5.3 (2013): 889-895.
Chicago
Fan, T., Xing, J., Lu, J., Liu, T., Xu, M., Zhang, Y., Shao, Q., Li, J., Yu, J."Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer". Oncology Letters 5, no. 3 (2013): 889-895. https://doi.org/10.3892/ol.2013.1137
Copy and paste a formatted citation
x
Spandidos Publications style
Fan T, Xing J, Lu J, Liu T, Xu M, Zhang YJ, Shao Q, Li J and Yu J: Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer. Oncol Lett 5: 889-895, 2013.
APA
Fan, T., Xing, J., Lu, J., Liu, T., Xu, M., Zhang, Y. ... Yu, J. (2013). Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer. Oncology Letters, 5, 889-895. https://doi.org/10.3892/ol.2013.1137
MLA
Fan, T., Xing, J., Lu, J., Liu, T., Xu, M., Zhang, Y., Shao, Q., Li, J., Yu, J."Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer". Oncology Letters 5.3 (2013): 889-895.
Chicago
Fan, T., Xing, J., Lu, J., Liu, T., Xu, M., Zhang, Y., Shao, Q., Li, J., Yu, J."Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer". Oncology Letters 5, no. 3 (2013): 889-895. https://doi.org/10.3892/ol.2013.1137
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