Role of Chemotherapy in Stage II Nasopharyngeal Carcinoma Treated with Curative Radiotherapy
Min Kyu Kang ; Dongryul Oh ; Chang Geol Lee ; Jin-Hee Kim ; Sung Hwan Kim ; Ji-Yoon Kim ; Young-Taek Oh ; Jin Hyoung Kang ; Yeon-Sil Kim ; Jun Won Kim ; Jihye Cha ; Ki Chang Keum ; Jun Su Park ; Hyo Jung Park ; Keunchil Park ; Yong Chan Ahn ; Dae-Seog Heo ; Hong-Gyun Wu ; Sung Ho Moon ; Kwan Ho Cho
Cancer Research and Treatment, Vol.47(4) : 871~878, 2015
Cancer Research and Treatment
PURPOSE: To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngeal carcinoma, we compared the treatment outcomes of patients treated with curative radiotherapy with or without chemotherapy.
MATERIALS AND METHODS: From 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002 stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitals in South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvant chemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in 80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gy to 74.2 Gy (median, 70 Gy).
RESULTS: Median follow-up was 48 months (range, 7 to 97 months) for all patients. At the last follow-up, 13 patients had died and 32 had experienced treatment failure; locoregional failure occurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival, and overall survival were 86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that the significant prognostic factors were concurrent chemotherapy and N stage for locoregional relapse-free survival, concurrent chemotherapy for progression-free survival, and age and N stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improved distant metastasis-free survival.
CONCLUSION: Concurrent chemotherapy significantly improved 5-year locoregional relapse-free survival and progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvant chemotherapy failed to improve either.