Concurrent chemoradiotherapy in locoregionally recurrent nasopharyngeal carcinoma |
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Authors: | Poon Donald Yap Swee-Peng Wong Zee-Wan Cheung Yin-Bun Leong Swan-Swan Wee Joseph Tan Terence Fong Kam-Weng Chua Eu-Tiong Tan Eng-Huat |
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Institution: | * Department of Medical Oncology, Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore ? Department of Therapeutic Radiology, Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore ? Biostatistics Unit, Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore |
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Abstract: | PURPOSE: To analyze the results of concurrent chemoradiotherapy in patients with locoregional recurrent nasopharyngeal carcinoma. METHODS AND MATERIALS: We performed a retrospective analysis of 35 patients with locoregional recurrent nasopharyngeal carcinoma referred to our department between March 1994 and November 2002. Most patients were male (77%), Chinese (97%), and had undifferentiated carcinoma (89%). Most had extensive locally recurrent Stage rT3-T4 disease (66%) with a median age at recurrence of 49 years (range, 35-69 years). A repeat course of radiotherapy was given concurrently with cisplatin, with cisplatin/5-fluorouracil as consolidation treatment. Significant morbidities were present, including cranial nerve palsies due to extensive recurrent local disease before treatment of the recurrence. RESULTS: The response rate to concurrent chemoradiotherapy was 58% (29% complete response and 29% partial response). The 5-year progression-free and overall survival rate, calculated using the Kaplan-Meier method, was 15% and 26%, respectively. Only 3 patients developed systemic metastases. Grade 3-4 acute toxicities included emesis (9%) and neutropenia (14%), and Grade 3-4 late toxicities consisted of temporal lobe necrosis (3%), cranial neuropathy (6%), and endocrine abnormalities (14%). CONCLUSION: Concurrent chemoradiotherapy is feasible in a selected group of patients with locoregional recurrent NPC, but the risk of major late toxicities is significant. |
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Keywords: | Concurrent chemoradiotherapy Recurrent nasopharyngeal carcinoma |
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