Alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil - A preliminary report of phase II study

Fuwa, Nobukazu; Kodaira, T.; Furutani, Kazuhisa; Tatibana, Hiroyuki; Toita, Takafumi; Shikama, Naoto; Kano, Masataka; Hayasi, N.; Yuta, Atsushi

doi:10.1200/jco.2004.22.90140.5613

Cited by 5 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alternating therapy facilitates administration of high-dose anticancer agents, since it causes milder mucositis than concurrent therapy. The results of our treatment in which alternating therapy was employed were good and the rate of treatment completion was also sufficiently high (28,29,39,40). When high-dose anticancer agents are required and the irradiation field is extensive, alternating therapy may be very significant.…”

Section: Discussionmentioning

confidence: 80%

“…Patients with nasopharyngeal cancer achieved good results (28,29). Initially, chemotherapy was administered, followed by 4 weeks of radiotherapy (irradiation method A; wide field irradiation) 2 days after chemotherapy, a second course of chemotherapy after 2 days, and a second course of a reduced field radiotherapy (irradiation method B) after 2 days.…”

Section: Patient Selectionmentioning

confidence: 99%

“…We employed this alternating therapy based on good results in patients with nasopharyngeal cancer and a low incidence of mucositis, which is a limitation of concurrent therapy with 5FU and radiation (28,29).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dose Escalation Study of Nedaplatin with 5-Fluorouracil in Combination with Alternating Radiotherapy in Patients with Head and Neck Cancer

Fuwa

Kodaira

Tachibana

et al. 2007

Japanese Journal of Clinical Oncology

Self Cite

View full text Add to dashboard Cite

Background: This study, with a large number of patients, confirms that after administration of 5-fluorouracil (5FU), a higher dose of nedaplatin (NDP) can be safely administered rather than a single therapy of NDP, as demonstrated in a phase I study. Methods: The subjects were 52 patients with stage II -IV (M0) head and neck cancer other than nasopharyngeal cancer. Alternating chemoradiotherapy was performed using the following method. Initially, chemotherapy was administered. For chemotherapy, 5FU at 700 mg/m 2 / 24 h was intravenously administered for 5 days (days 1 -5), and NDP was administered on day 6. We established three dose groups: level 1, 120 mg/m 2 ; level 2, 140 mg/m 2 ; and level 3, 150 mg/m 2 (n ¼ 13 or more per group). Results: The maximum acceptable dose of NDP (150 mg/m 2 ) was confirmed. The 5-year overall survival rates were 77% (95% CI: 66 -90%) in all subjects and 75% (95% CI: 61 -92%) in the stage III/IV patients. The 5-year progression-free survival rates were 73% (95% CI: 62 -87%) in all subjects and 72% (95% CI: 57 -89%) in the stage III/IV patients. Conclusions: After administration of 5FU, a higher dose of NDP can be safely administered. This alternating chemoradiotherapy showed potent antitumor effects. The efficacy of chemotherapy with NDP and 5FU should be compared to that of chemotherapy with CDDP and 5FU.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Patient Selectionmentioning

confidence: 99%

See 1 more Smart Citation

Dose Escalation Study of Nedaplatin with 5-Fluorouracil in Combination with Alternating Radiotherapy in Patients with Head and Neck Cancer

Fuwa

Kodaira

Tachibana

et al. 2007

Japanese Journal of Clinical Oncology

Self Cite

View full text Add to dashboard Cite

show abstract

“…7,28 For this combination, RT and CT are given alternately, without a treatment gap, to minimize excessive toxic effects on normal tissues and to enhance the tumor response by perturbing cell cycling or reoxygenation. Several clinical trials involving alternating schedules have yielded promising results.…”

Section: Concurrent Ctmentioning

confidence: 99%

Rationale for chemoradiotherapy

Nishimura

2004

Int J Clin Oncol

View full text Add to dashboard Cite

The rationale for combining chemotherapy (CT) and radiotherapy (RT) is based mainly on two ideas, one being spatial cooperation and the other the enhancement of radiation effects. Spatial cooperation is effective if CT is sufficiently active to eradicate subclinical metastases and if the primary local tumor is effectively treated by RT. In this regard, no interaction between RT and CT is required, but differing toxicities are needed so that both modalities can be used at effective dosages. To enhance RT by CT, five major mechanisms of CT-RT interactions are required. CT can enhance RT effects by: (1) direct enhancement of the initial radiation damage by incorporating drugs into DNA, (2) inhibiting cellular repair, (3) accumulating cells in a radiosensitive phase or eliminating radioresistant phase cells, (4) eliminating hypoxic cells, or (5) inhibiting the accelerated repopulation of tumor cells. However, virtually all chemotherapeutic agents enhance radiation damage to normal tissues as well. Consequently, therapeutic benefits are only achieved if the enhanced tumor response is greater than that for normal tissues. Due to the complex interaction between CT and RT, the sequence of CT and RT is important. Clinical results of induction CT followed by RT are disappointing, and improvements in local control rates of RT by induction CT have not been observed. On the other hand, clinical trials, including metaanalyses, have clearly shown that CT given concurrently with RT results in improved local control and survival. Although acute toxicities are inevitably increased in concurrent chemoradiotherapy (CRT), no significant increases in late toxicities were reported in most clinical trials. Thus, a therapeutic benefit was observed with the use of concurrent CRT.

show abstract

“…The same chemotherapy regimen was used in the remaining treatments. Subsequently chemotherapy, radiotherapy (30 Gy in 15 fractions), and chemotherapy were alternately performed, with a curative intent (10,11). The assessment of the therapeutic response using CT and MRI at two months after alternating chemoradiotherapy revealed a complete reduction of the primary tumor as well as smaller, but remaining, cervical lymph nodes.…”

Section: Case Reportmentioning

confidence: 99%

Nasopharyngeal Carcinoma with Bone Marrow Metastasis: Positive Response to Weekly Paclitaxel Chemotherapy

et al. 2015

View full text Add to dashboard Cite

A 51-year-old man with nasopharyngeal carcinoma underwent chemoradiotherapy with cisplatin and 5-fluorouracil, followed by a left cervical lymphadenectomy. Distant metastatic disease was excluded using fluoro-deoxyglucose positron emission tomography. Seven months later, bone marrow metastasis and disseminated intravascular coagulation were diagnosed. The patient received weekly paclitaxel therapy and maintained a good performance status for seven months. During the treatment period, the patient developed no severe organ toxicity except for neutropenia. Weekly paclitaxel may therefore be considered as the treatment of choice in patients with advanced or recurrent nasopharyngeal carcinoma with bone marrow metastasis.

show abstract

Alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin and 5-fluorouracil - A preliminary report of phase II study

Cited by 5 publications

References 0 publications

Dose Escalation Study of Nedaplatin with 5-Fluorouracil in Combination with Alternating Radiotherapy in Patients with Head and Neck Cancer

Dose Escalation Study of Nedaplatin with 5-Fluorouracil in Combination with Alternating Radiotherapy in Patients with Head and Neck Cancer

Rationale for chemoradiotherapy

Nasopharyngeal Carcinoma with Bone Marrow Metastasis: Positive Response to Weekly Paclitaxel Chemotherapy

Contact Info

Product

Resources

About