Concurrent Chemotherapy-Radiotherapy Compared With Radiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: Progression-Free Survival Analysis of a Phase III Randomized Trial

Chan, Anthony T.C.; Teo, Peter M.L.; Ngan, Roger K.C.; Leung, Thomas W.T.; Lau, W.S.; Zee, Benny; Leung, Sing-fai; Cheung, Fanny M.; Park, Yeon Hee; Yiu, Harry; Yu, Kin Wah; Chiu, K.W.; Chan, Danny; Mok, Tony; Yuen, Kam‐Tong; Mo, Frankie; Lai, Manhong; Kwan, W. H.; Choi, Peter; Johnson, Philip J.

doi:10.1200/jco.2002.08.149

Cited by 440 publications

(307 citation statements)

References 21 publications

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“…To the best of our knowledge, there have been nine phase III randomised trials to investigate the role of combined chemoradiotherapy in NPC so far (Rossi et al, 1988;Chan et al, 1995Chan et al, , 2002Cvitkovic and INCSG, 1996;Al-Sarraf et al, 1998;Chua et al, 1998;Ma et al, 2001;Chi et al, 2002;Hareyama et al, 2002). Table 5 summarises the results.…”

Section: Discussionmentioning

confidence: 99%

“…Although this is the only randomised trial of positive results in survival analysis, its wide application to non-American NPC patients should be considered with caution. First, about 30% patients of the Intergroup study have WHO type I histology (keratinising squamous cell carcinoma), but European (Cvitkovic et al, 1996), Japanese (Hareyama et al, 2002), or Chinese (Chan et al, 1995(Chan et al, , 2002Chua et al, 1998;Ma et al, 2001;Chi et al, 2002) series usually contain less than 5% WHO type I patients. Second, the survival data of radiotherapy alone are unexplainedly low -24% 3-year progression-free survival rate and 47% 3-year overall survival rate.…”

Section: Discussionmentioning

confidence: 99%

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Outpatient weekly neoadjuvant chemotherapy followed by radiotherapy for advanced nasopharyngeal carcinoma: high complete response and low toxicity rates

Jiang

et al. 2003

Br J Cancer

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outpatient weekly neoadjuvant chemotherapy followed by radiotherapy for advanced nasopharyngeal carcinoma: high complete response and low toxicity rates

Jiang

et al. 2003

Br J Cancer

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“…[29][30][31][32][33][34][35][36][37][38][39] One negative adjuvant chemotherapy trial used a noncisplatin combination and was carried on before the introduction of cisplatin-5FU in this disease. Of four induction chemotherapy trials, two used combinations without cisplatin-5FU, and the other two used cisplatin-5FU combinations.…”

Section: Nasopharyngeal Cancermentioning

confidence: 99%

Treatment of Locally Advanced Head and Neck Cancer: Historical and Critical Review

Al‐Sarraf

2002

Cancer Control

105

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Background Advanced squamous cell cancers of the head and neck have traditionally been associated with high rates of morbidity and mortality. Advances in management have improved outcomes for most of these patients. Methods The author reviews the historical progress in management of these difficult tumors and adds his own wide experience to describe and evaluate newer approaches to management. Results Over the last 10 years, overall survival rates for patients with head and neck cancers have improved as has quality of life. New standards of care have been defined for patients with nasopharyngeal cancer and for those with advanced unresectable disease. Organ preservation is more commonly achieved. Conclusions Newer targeted therapies are likely to add to the progress that has already been achieved in the multimodality management of patients with head and neck cancers.

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“…However in patients with more advanced disease stages (UICC stage III and IV), recurrence is common and, consequently, 5-yr survival rates are only 45-60%. Recent studies have demonstrated an improvement of progression-free survival with concurrent cisplatin and RT compared with RT alone, and the improvement was statistically significant in patients with advanced disease (12). Unfortunately concurrent cisplatin and RT resulted in considerable toxicity.…”

Section: Discussionmentioning

confidence: 99%

Serum proteomic pattern for predicting recurrence of undifferentiated nasopharyngeal carcinoma after radiotherapy

et al. 2004

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Although most patients with early-stage nasopharyngeal carcinoma (NPC) can be cured by radiotherapy, there is a high recurrence rate in patients with advanced NPC. We attempted to identify proteomic patterns in sera for predicting tumor recurrence. Pretreatment sera were collected from 64 NPC patients with complete remission after radiotherapy. Serum proteins were profiled by SELDI ProteinChip technology, and correlated with local/distant recurrence.Forty proteomic features were significantly different between the patient groups with and without tumor recurrence. Univariate analyses showed that 32 of them were significantly associated with time to first recurrence. Multivariate Cox-regression analyses identified International Union Against Cancer (UICC) stage and two proteomic features with mass/charge (m/z) values of 8808 and 6626 as independent prognostic indicators for tumor recurrence. The hazard ratios were 2.0 (95% confidence interval, CI 1.3-3.2) and 0.79 (95% CI 0.64-0.96) for a double of peak intensity of proteomic feature m/z 8808 and m/z 6626, respectively. These two proteomic features were also independent prognosticators for overall survival. A decision tree was constructed to predict the tumor recurrence by using UICC stage, proteomic feature m/z 8808, and proteomic feature m/z 6626, and evaluated by Leave-One-Out crossvalidation. Kaplan-Meier analysis confirmed that the decision tree could predict both recurrencefree survival and overall survival. The positive and negative predictive values for tumor recurrence within 4 yr were 74 and 89%, respectively.A serum proteomic pattern comprising features m/z 8808 and m/z 6626 is a potential surrogate marker of disease recurrence after radiotherapy in NPC.

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Concurrent Chemotherapy-Radiotherapy Compared With Radiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: Progression-Free Survival Analysis of a Phase III Randomized Trial

Abstract: Concurrent CRT is well tolerated in patients with advanced NPC in endemic areas. Although PFS was not significantly different between the concurrent CRT arm and the RT-alone arm in the overall comparison, PFS was significantly prolonged in patients with advanced tumor and node stages.

Cited by 440 publications

References 21 publications

Outpatient weekly neoadjuvant chemotherapy followed by radiotherapy for advanced nasopharyngeal carcinoma: high complete response and low toxicity rates

Outpatient weekly neoadjuvant chemotherapy followed by radiotherapy for advanced nasopharyngeal carcinoma: high complete response and low toxicity rates

Treatment of Locally Advanced Head and Neck Cancer: Historical and Critical Review

Serum proteomic pattern for predicting recurrence of undifferentiated nasopharyngeal carcinoma after radiotherapy

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