You are here

NAZOFARENGEAL KARSİNOMLU 100 HASTANIN RETROSPEKTİF ANALİZİ

A RETROSPECTIVE STUDY ON 100 NASOPHARYNGEAL CARCINOMA PATIENTS

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Objective: The aim of this retrospective study was to analyse the survival and recurrens patterns of 100 non-metastatic nasopharyngeal carcinoma patients. Materials and methods: A retrospective study in 100 nasopharyngeal carcinoma patients treated between 1991 and 2003 was performed. 76 received cisplatin based neoadjuvant chemotherapy for two or four courses prior to definitive radiotherapy and 24 were treated by radical radiotherapy alone. The total dose delivered to nasopharynx, lymph nodes and servical region (if affected) was 66-70 Gy, 50 Gy and 15-20 Gy respectively. Results: Twenty patients had stage II, 47 had stage III and 33 had stage IV disease (according to AJCC 1997 staging system). All patients were diagnosed as nasopharyngeal squamous cell carcinoma (18 WHO I-II and 82 WHO III). Minimum follow-up period was two years. Overall response after induction chemotherapy was 75% (with 13.2% complet response and 61.8% partial response). 13 patients had stable disease (17.1%), whereas 6 patients (7.9%) had progressive disease. Failure rate after radiotherapy was 53%. Locoregional recurrence was 56.6%, locoregional recurrence and distant failure was 28.3% and isolated distant failure was 15.1%. The five years overall survival was 57.1% for radiotherapy alone and 57.7% for the chemoradiotherapy. Conclusion: Induction chemotherapy neither improved the teratment outcome nor altered the failure patterns in patients with nasopharyngeal carcinoma.
Abstract (Original Language): 
Amaç: Bu retrospektiv çal›flman›n amac›, nonmetastatik nazofarengeal karsinomlu 100 hastan›n survi ve rekürrens paternini analiz etmekti. Gereç ve yöntem : 1991-2003 y›llar› aras›nda tedavi edilen 100 nazofarengeal karsinomlu hasta retrospektif olarak incelendi. 24’ü yaln›z radyoterapi ile tedavi edilirken, 76’s›na kombine model tedavi (cisplatin bazl› 2-4 kür neoadjuvant kemoterapi ve radyoterapi) uygulanm›flt›. Nazofarengeal bölgeye 66-70 Gy, lenf nodlar›na 50 Gy, servikal hastal›k mevcut ise tutulan alana 15-20 Gy boost dozu verilmiflti. Bulgular: AJCC 1997 evreleme sistemine göre, hastalar›n 20’si evre II, 47’si evre III, 33’ü evre IV’tü. Tüm hastalar skuamoz hücreli nazofarengial karsinom tan›s› alm›flt› (18 WHO I-II, 82 WHO III). Minimum takip süresi 2 y›ld›. ‹ndüksiyon kemoterapisine yan›t oran› %75 (%13,2 tam ve %61,8 k›smi), yan›ts›z olanlar›n oran› (progresif hastal›k) %7,9 ve stabil hastal›k oran› %17,1’di. Radyoterapi sonras› baflar›s›zl›k oran› %53’tü. Bunlar›n %56,6’s› lokoregional nüks, %28,3’ü lokoregional nüks ve uzak metastaz ve %15,1’i izole metastazd›. 5 y›ll›k genel sa¤ kal› m yaln›z radyoterapi verilenlerde %57,1, kombine tedavi verilenlerde %57,7 idi. Sonuç: ‹ndüksiyon kemoterapisi nazofarengeal karsinomlu hastalarda tedavi sonuçlar›n› ve baflar›s›zl›k paternini de¤ifltirmemifltir.
10-14

REFERENCES

References: 

1. Al-Sarraf M, Reddy MS. Nasopharyngeal carcinoma. Curr Treat
Options Oncol 2002; 3:21-32.
2. Chan AT, Teo PM, Leung TW, Leung SF, Lee WY, Yeo W, Choi
PH, Johnson PJ. A prospective randomized study of chemotherapy
adjunctive to definitive radiotherapy in advanced nasopharyngeal
carcinoma. Int J Radiat Oncol Biol Phys 1995;
33:569-577.
3. Cheng SH, Yen KL, Jian JJ, Tsai SY, Chu NM, Leu SY, Chan
KY, Tan TD, Cheng JC, Hsieh CY, Huang AT. Examining prognostic
factors and patterns of failure in nasopharyngeal carcinoma
following concomitant radiotherapy and chemotherapy: impact
on future clinical trials. Int J Radiat Oncol Biol Phys 2001;
50:717-726.
4. Cheng SH, Jian JJ, Tsai SY, Yen KL, Chu NM, Chan KY, Tan
TD, Cheng JC, Leu SY, Hsieh CY, Huang AT. Long-term survival
of nasopharyngeal carcinoma following concomitant radiotherapy
and chemotherapy. Int J Radiat Oncol Biol Phys 2000;
48:1323-1330.
5. Chua DT, Ma J, Sham JS, Mai HQ, Choy DT, Hong MH, Lu
TX, Min HQ. Long-term survival after cisplatin-based induction
chemotherapy and radiotherapy for nasopharyngeal carcinoma:
a pooled data analysis of two phase III trials. J Clin Oncol 2005;
23:1118-1124.
6. Chua DT, Sham JS, Wei WI, Ho WK, Au G, Choy D. Control of
regional metastasis after induction chemotherapy and radiotherapy
for nasopharyngeal carcinoma. Head Neck 2002; 24:350-
360.
7. Chua DT, Sham JS, Choy D, Lorvidhaya V, Sumitsawan Y,
Thongprasert S, Wootiprux V, Cheirsilpa A, Azhar T, Reksodiputro
AH. 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. Asian-Oceanian Clinical Oncology Association
Nasopharynx Cancer Study Group. Cancer 1998;
83:2270-2283.
8. Chua DT, Sham JS, Choy D, Kwong DL, Au GK, Kwong PW,
Yau CC, Cheng AC, Wan KY. Patterns of failure after induction
chemotherapy and radiotherapy for locoregionally advanced nasopharyngeal
carcinoma: the Queen Mary Hospital experience.
Int J Radiat Oncol Biol Phys 2001; 49:1219-1228.
9. Daniilidis J, Constantinidis J, Fountzilas G. Combined radiochemotherapy
in locally advanced nasopharyngeal carcinoma HNO
2001; 49:732-738.
10. Farias TP, Dias FL, Lima RA, Kligerman J, de Sa GM, Barbosa
MM, Goncalves FB Jr. Prognostic factors and outcome for nasopharyngeal
carcinoma. Arch Otolaryngol Head Neck Surg
2003; 129:794-799.
11. Fonseca E, Cruz JJ, Rodriguez CA, Gomez-Bernal A, Martin A,
Sanchez P, Nieto A, Soria P, Vega MJ, Munoz A, Pardal JL. Neoadjuvant
chemotherapy with continuous infusion of cisplatin
and 5-fluorouracil, with or without leucovorin, for locally advanced
nasopharyngeal carcinoma. J Infus Chemother 1996; 6:217-
220
12. Geara FB, Glisson BS, Sanguineti G, Tucker SL, Garden AS,
Ang KK, Lippman SM, Clayman GL, Goepfert H, Peters LJ. Induction
chemotherapy followed by radiotherapy versus radiotherapy
alone in patients with advanced nasopharyngeal carcinoma:
results of a matched cohort study. Cancer 1997; 79:1279-
1286.
13. Gruner A, Grabenbauer GG, Rodel C, Weidenbecher M, Martus
P, Iro H, Sauer R. Nasopharyngeal carcinoma: only irradiation or
simultaneous radiochemotherapy? Strahlenther Onkol 1999;
175:591-596.
14. Hareyama M, Sakata K, Shirato H, Nishioka T, Nishio M, Suzuki
K, Saitoh A, Oouchi A, Fukuda S, Himi T. A prospective,
randomized trial comparing neoadjuvant chemotherapy with radiotherapy
alone in patients with advanced nasopharyngeal car-
100 nasopharyngeal carcinoma patients
‹stanbul T›p Fakültesi Dergisi Cilt / Volume: 69 • Say› / Number: 1 • Y›l/Year: 2006
- 13 -
cinoma.Cancer 2002; 94:2217-2223.
15. Hong S, Wu HG, Chie EK, Bang YJ, Heo DS, Kim KH, Sung
MW, Park CI. Neoadjuvant chemotherapy and radiation therapy
compared with radiation therapy alone in advanced nasopharyngeal
carcinoma. Int J Radiat Oncol Biol Phys 1999; 45:901-905.
16. Huncharek M, Kupelnick B. Combined chemoradiation versus
radiation therapy alone in locally advanced nasopharyngeal carcinoma:
results of a meta-analysis of 1,528 patients from six randomized
trials. Am J Clin Oncol 2002; 25:219-223.
17. Langendijk JA, Leemans CR, Buter J, Berkhof J, Slotman BJ.
The additional value of chemotherapy to radiotherapy in locally
advanced nasopharyngeal carcinoma: a meta-analysis of the
published literature. J Clin Oncol 2004; 22:4604-4612.
18. Ma BB, Chan AT. Recent perspectives in the role of chemotherapy
in the management of advanced nasopharyngeal carcinoma.
Cancer 2005; 103:22-31.
19. Ma J, Mai HQ, Hong MH, Min HQ Mao ZD, Cui NJ, Lu TX,
Mo HY. Results of a prospective randomized trial comparing neoadjuvant
chemotherapy plus radiotherapy with radiotherapy
alone in patients with locoregionally advanced nasopharyngeal
carcinoma. J Clin Oncol 2001; 19:1350-1357
20. Ozyar E, Gurkaynak M, Yildiz F, Atahan IL. Non-metastatic stage
IV nasopharyngeal carcinoma patients: analysis of the pattern
of relapse and survival. Radiother Oncol 2004; 72:71-77.
21. Rischin D, Corry J, Smith J, Stewart J, Hughes P, Peters L. Excellent
disease control and survival in patients with advanced nasopharyngeal
cancer treated with chemoradiation. J Clin Oncol
2002; 20:1845-1852.
22. Teo PM, Chan AT, Lee WY, Leung TW, Johnson PJ. Enhancement
of local control in locally advanced node-positive nasopharyngeal
carcinoma by adjunctive chemotherapy. Int J Radiat
Oncol Biol Phys 1999; 43:261-271.

Thank you for copying data from http://www.arastirmax.com