Preliminary report of the asian-oceanian clinical oncology association randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma

Is chemotherapy beneficial in the treatment of locoregionally advanced nasopharyngeal carcinoma?

“…Geara et al 5 further stated that the M. D. Anderson Cancer Center's singleinstitution, nonrandomized study showing the beneficial effects of chemotherapy for patients with nasopharyngeal carcinoma "could be considered confirmatory of these two recent trials." However, in this issue of Cancer, Chua et al, 6 citing the same VUMCA trial, noted that "No survival benefit could be demonstrated with the addition of neoadjuvant chemotherapy in the current study and in the International Nasopharyngeal Cancer Study Group trial" and concluded that "routine administration of neoadjuvant chemotherapy in this target group is not recommended." As such, the same study lends itself to different interpretations for either the advocates or the opponents of neoadjuvant chemotherapy.…”

“…In this issue of Cancer, Chua et al 6 report the preliminary results of the Asian-Oceanian Clinical Oncology Association's randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. The authors reported no significant gain in relapse free and overall survival with the addition of neoadjuvant chemotherapy and concluded that they could not recommend the routine administration of neoadjuvant chemotherapy for this group of patients.…”

“…However, as this article's data and the data from the International Nasopharynx Cancer Study Group (two of the largest sources of randomized data) indicate, there is no improvement in overall survival with chemotherapy. 6,9 Prior to comparing the results of the trial reported by Chua et al to other recent randomized studies of the treatment of nasopharyngeal carcinoma, several salient features of the article will be discussed herein.…”

Wo stehen wir bei der Behandlung des Nasopharynxkarzinoms?

“…Nach Abschluss einer Phase-II-Studie zur neoadjuvanten Chemotherapie mit Cisplatin und Epirubicin begann die Asian-Oceanian Clinical Oncology Association eine prospektiv randomisierte multizentrische Phase-III-Studie [14]. Von September 1989 bis August 1993 wurden 334 Patienten mit undifferenziertem oder schlecht differenziertem Nasopharynxkarzinom im Stadium III/IV nach Ho rekrutiert.…”

Inverse Treatment Planning and Stereotactic Intensity-Modulated Radiation Therapy (IMRT) of the Tumor and Lymph Node Levels for Nasopharyngeal Carcinomas

“…Traditionally, based on the anatomic location and the high radiosensitivity, the NPC is treated by radiation therapy with or without chemotherapy [1,9,11,20]. About 80% of the patients show cervical lymph node involvement at first presentation [26].…”