Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy

Jian, James Jer-Min; Cheng, Skye Hongiun; Tsai, Shih Chang; Yen, Kuo‐Yang; Chu, Nai‐Shin; Chan, Kwan-Yee; Tan, Tran-Der; Cheng, Jason Chia‐Hsien; Lin, Yen–Chun; Leu, Szu-Yun; Hsieh, Cheng-I; Tsou, Mei-Hua; Lin, Ching-Yuan; Huang, Andrew T.

doi:10.1016/s0360-3016(02)02709-8

Cited by 40 publications

(24 citation statements)

References 26 publications

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“…However, the results of conventional radiotherapy are not satisfactory, especially in locally advanced tumors [15,52,57]. In the last decades, several innovative treatment strategies have been investigated including irradiation and comcomitant chemotherapy [2, 6-8, 11, 12, 21, 26, 29, 43, 44, 54] as well as altered fractionation of radiotherapy [3,9,28,29,34,35,38,42,[66][67][68][69][70]. Unlike other locally advanced head and neck cancers where altered regimens have been widely tested within large prospective phase III trials [18,22,23,49,53,56,59], reports on altered fractionation in nasopharyngeal carcinoma are scarce.…”

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confidence: 99%

Hyperfractionated Radiotherapy in Locally Advanced Nasopharyngeal Cancer

et al. 2004

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Hyperfractionated radiotherapy seems a feasible and active regimen in locally advanced nasopharyngeal carcinoma. Accompanying acute and late toxicity is acceptable and does not compromise delivery of the planned irradiation dose. This regimen is associated with a high local control rate; relatively high nodal and distant failure, however, call for further treatment modifications, e. g., optimization of irradiation technique and/or dose escalation as well as improved systemic therapies.

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Hyperfractionated Radiotherapy in Locally Advanced Nasopharyngeal Cancer

et al. 2004

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“…HFRT ile kombine kemoterapinin etkilerini araştıran bir çalışmada T3-T4 nazofarenks kanserlerinde toplam 74.4 Gy RT 57 aylık ortalama takip 3 yıllık lokal-bölgesel kontrol %93, hastalıksız sağkalım %71, genel sağkalım % 72 olarak bildirilmiş. % 73 grade 3 mukozit görülmüş, hastaların % 88'i radyoterapiyi 8 hafta içinde tamamlamış (15 Akselere fraksiyon ve konkomitant boost kolunda grade 3 ve daha ileri yan etkilerin daha fazla görüldüğü saptanmıştır. Yapılan birçok çalışmada farklı fraksiyon şemalarında akut mukozit tedavi uygulamada sınırlayıcı bir etken olarak gösterilmektedir (22,23).…”

Section: Discussionunclassified

Epidermoid Baş-Boyun Kanserlerinin Tedavisinde Hiperfraksiyone Radyoterapi Sonuçları

Hiçsönmez¹,

Güney²,

Dizman³

et al. 2004

Ankara Sa

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ÖZETAmaç: Çalışmamızda epidermoid baş-boyun kanserlerinde Hiperfraksiyone Radyoterapi (HFRT)'nin lokal-bölgesel kontrole olan etkilerini, akut ve geç yan etkiler açısından tedavinin hastalar tarafından ne derece tolere edilebileceğinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Mart 1995-Şubat 1996 arasında, baş-boyunun çeşitli bölgelerinden (Nazofarenks, Larenks, Oral kavite, Maksiler sinüs) orjin alan 30 epidermoid karsinomlu hasta HFRT küratif RT protokolüne dahil edildi. 25 hasta değerlendirmeye alındı. Yaşları 15-80 arasındaydı ( ortalama yaş 45.5). Primer tümör ve üst boyun bölgesi 1.2 Gy/fraksiyon (frk) 6 saat ara ile günde iki defa tedavi edildi. Total tedavi dozu 60-74.4 Gy arasında idi.Sonuç: Hastalar minimum 2 ay, maksimum 9 ay takip edildi. 18 hastada servikal lenfatik tutulum vardı (N+). 18 hasta evre IV, 4 hasta evre III, 2 hasta evre II, 1 hastada evre I'di. % 56 (14 hasta) hastada lokal bölgesel tam cevap sağlandı. Primer tümör (lokal) komplet cevap oranı % 56'dır. Tutulmuş servikal lenfatiklerin (bölgesel) komplet cevap oranı % 83'dür. Bölgesel cevap primer cevaba oranla daha yüksek oranda sağlandı. %40 (10 hasta) hastada parsiyel cevap alındı. Hastalarda verilen doz ile lokal kontrol arasında bir ilişki görülmedi. Tedavi hastalar tarafından iyi tolere edildi. Hiçbir hastada grade 4 toksisite görülmedi. Akut reaksiyonlar ile tedaviye ara verilme oranı % 28'dir. Takip süresi içinde % 36 oranında grade 1 geç radyasyon ödemi, hastaların % 24'ünde grade 3 ağız kuruluğu ve tad kaybı, % 8 hastada grade 1 disfaji gözlendi.Tartışma: Baş boyun kanserli hastalarda hiperfraksiyone radyoterapi kabul edilebilir yan etkilerle uygun bir şemadır. Anahtar sözcük:Hiperfraksiyone, Radyoterapi, Baş-boyun kanserleri ABSTRACT Purpose: The optimal fractionation schedule for radiotherapy of head and neck cancer has been controversial. The objective of this study was to test the efficacy of hyperfractionation radiotherapy on patients with head and neck cancer. Methods and Materials:Between March 1995-February 1996, 30 patients with head and neck tumors (Nasopharynx, oral cavity, larynx and maksiler sinus) were treated hyperfraction radiotherapy. 25 patients were evaluated. The mean age was 45.5. Fractions used were 1.2 Gy twice-a-day with a curative intent on all patients, to a total mean dose 60-74.4 Gy.Results: With a follow-up of min 2 months-9 months. 18 patients had cervical lymphadenopaty (N+). The number of of patients at each clinical stage were as follows: stage IV ,18; stage III, 4; stage II, 2; Stage I, 1. Loca-regional complete response was observed in % 56 (14 patients). Local complet response rate was % 56, regional complete response rate was % 83. Regional response rate was higher than local response rate. %40 (10 patients) had parsiyal response. No relations was observed between dose and local control rate. No patients had grade 4 toxicity. % 28 patients had require treatment interuptions due to acute reactions. Severe late toxicity was not

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“…Another way of improving the effectiveness of standard concurrent chemo-radiotherapy may be to modify the radiotherapy scheme. In a phase Ⅱ trial, Jian et al [15] investigated the activity of hyperfractionated radiotherapy and concomitant platinum-based chemotherapy. As a result, three-year overall survival rate was 72%, with 73% of patients showing grade 3 mucositis, 31% of patients experiencing severe weight loss and 15% requiring a feeding tube.…”

Section: Chemoradiotherapymentioning

confidence: 99%

Locally advanced nasopharyngeal carcinoma: Current and emerging treatment strategies

Perri¹

2011

WJCO

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Although nasopharyngeal carcinoma (NPC) is a widespread malignant tumor, it is particularly frequent in Southeast Asia. Although T1 tumors can be effectively controlled with exclusive radiotherapy, this treatment modality is insufficient for most NPC patients, who present with locally advanced disease at diagnosis. In fact, for stages ranging from T2b N0 to T4 N3, definitive scientific evidence supports the use of concurrent platinum-based chemotherapy with standard external beam radiotherapy. This treatment approach has shown a statistically significant advantage in terms of overall survival, with respect to radiotherapy alone. Several trials have also investigated the use of neoadjuvant and adjuvant chemotherapy in combination with radiotherapy or chemo-radiotherapy. Platinum compounds, anthracyclines and taxanes are among the chemotherapy agents employed. This review focuses on the clinical results obtained in the field of adjuvant/concurrent/ neoadjuvant chemotherapy for locally advanced NPC, for which exclusive concurrent chemo-radiotherapy currently represents the standard treatment approach.

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Improvement of local control of T3 and T4 nasopharyngeal carcinoma by hyperfractionated radiotherapy and concomitant chemotherapy

Cited by 40 publications

References 26 publications

Hyperfractionated Radiotherapy in Locally Advanced Nasopharyngeal Cancer

Hyperfractionated Radiotherapy in Locally Advanced Nasopharyngeal Cancer

Epidermoid Baş-Boyun Kanserlerinin Tedavisinde Hiperfraksiyone Radyoterapi Sonuçları

Locally advanced nasopharyngeal carcinoma: Current and emerging treatment strategies

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