Chemotherapy with or without radiotherapy in patients with locoregionally recurrent nasopharyngeal carcinoma

Wong, Zee-Wan; Tan, Eng‐Huat; Yap, Swee-Peng; Tan, Terence; Leong, S. S.; Fong, Kok‐Yong; Wee, Joseph

doi:10.1002/hed.10098

Cited by 15 publications

(17 citation statements)

References 7 publications

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“…Cisplatin-based chemotherapy (cisplatin alone or cisplatin plus other one or two anti-tumor drugs, including 5-fluorouracil, paclitaxel and gemcitabine) was administered to 37 patients treated with RT and 44 patients without RT. In the re-RT+/-chemtherapy group, eight patients underwent concurrent chemotherapy, 17 patients underwent induction chemotherapy, and 12 patients underwent both induction and concurrent chemotherapy [ 18 , 19 , 22 , 23 ]. In the non-RT + chemtherapy group, after undergoing two to six cycles of chemotherapy, oral tegafur-uracil or capecitabine was administered to 29 patients for maintenance chemotherapy until disease progression or death.…”

Section: Methodsmentioning

confidence: 99%

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With or without reirradiation in advanced local recurrent nasopharyngeal carcinoma: a case–control study

et al. 2016

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BackgroundThe study aimed to evaluate the long-term outcome in patients with advanced local recurrent nasopharyngeal carcinoma (NPC) treated with or without reirradiation.MethodsA total of 44 patients treated without reirradiation (non-RT + chemotherapy) were matched with 44 patients treated with reirradiation (re-RT+/-chemtherapy) by age, sex, Karnosky performance score (KPS), rT stage, rN stage, and time interval between initial radiation and recurrence (TI). Overall survival (OS) rate and time to progression (TTP) rate were assessed using Kaplan–Meier method, log-rank test, and Cox regression analysis.ResultsFrom March 2008 to December 2013, a total of 88 well-balanced rT3–4 N0-1 NPC patients were retrospectively analyzed. After a median follow-up of 27 months (range: 6–85), the 5-year OS rate and TTP rate was 23.4 %, 39.0 % in the non-RT + chemotherapy group and 27.5 %, 49.8 % in the re-RT+/-chemtherapy group, respectively. Multivariate analysis showed that significant toxic effect was the only significant prognosticator correlated with OS (HR: 2.15, 95 % CI = 1.02–4.53, p = 0.044). No statistically significant survival differences were observed between the two treatment groups in either univariate or multivariate analyses.ConclusionCompared with reiradiation, treating advanced local recurrent NPC with chemotherapy alone warrants further validation in the view of its similar survival and more acceptable toxicities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2803-2) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

“…Then chemotherapy became the alternative treatment method for these patients. However, chemotherapy has been considered a palliative therapy in the salvage treatment of local recurrent disease [ 18 , 19 ]. In fact, the efficacy of chemotherapy in treating advanced local recurrent NPC has not yet been fully evaluated.…”

Section: Introductionmentioning

confidence: 99%

With or without reirradiation in advanced local recurrent nasopharyngeal carcinoma: a case–control study

et al. 2016

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“…However, whether patients with rnpc can benefit from adjuvant chemotherapy remains controversial. Wong et al 76 retrospectively analyzed 42 cases of rnpc and showed that, compared with palliative cisplatin-5fu, concurrent chemoradiotherapy followed by adjuvant cisplatin-5fu led to better local control (58% vs. 38%); however, no significant differences in os were observed. Nakamura et al 79 treated 36 rnpc cases with chemoradiotherapy.…”

Section: The Role Of Chemotherapymentioning

confidence: 99%

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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Recurrent nasopharyngeal carcinoma, which represents a small proportion of head-and-neck cancers, has a unique set of patho-clinical characteristics. The management of recurrent nasopharyngeal carcinoma remains a challenging clinical problem. Traditional treatments offer limited local control and survival benefits; more seriously, they frequently induce severe late complications. Recently, novel treatment techniques and strategies—including precision radiotherapy, endoscopic surgery or transoral robotic resection, third-generation chemotherapy regimens, and targeted therapies and immunotherapy—have provided new hope for patients with recurrent nasopharyngeal carcinoma. Some of these patients can potentially be cured with modern treatments. However, a lack of adequate evidence makes it difficult for clinicians to apply these powerful techniques and strategies. Individualized management guidelines, full evaluation of quality of life in these patients, and a further understanding of the mechanisms underlying recurrence are future directions for research into recurrent nasopharyngeal carcinoma.

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“…We recently reported our preliminary experience in the use of chemotherapy with and without concurrent RT in such a cohort of patients (7). Otherwise, the use of concurrent chemoradiotherapy for the treatment of patients with locoregional recurrent NPC has not been previously addressed, although its role as primary treatment at initial diagnosis is quite well established (8,9).…”

Section: Introductionmentioning

confidence: 98%

Concurrent chemoradiotherapy in locoregionally recurrent nasopharyngeal carcinoma

Poon

Yap

Wong

et al. 2004

International Journal of Radiation Oncology*Biology*Physics

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Chemotherapy with or without radiotherapy in patients with locoregionally recurrent nasopharyngeal carcinoma

Abstract: Concurrent chemoradiotherapy for locoregional recurrent NPC seems promising. The morbidity experienced resulted from locoregional disease with few progressing to develop systemic involvement.

Cited by 15 publications

References 7 publications

With or without reirradiation in advanced local recurrent nasopharyngeal carcinoma: a case–control study

With or without reirradiation in advanced local recurrent nasopharyngeal carcinoma: a case–control study

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

Concurrent chemoradiotherapy in locoregionally recurrent nasopharyngeal carcinoma

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