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Purpose: The standard treatment of locally advanced
nasopharyngeal cancer is a concurrent chemoradiotherapy
(CCRT), and cisplatin has been used as the most
popular chemotherapeutic agent. But many different
doses and schedules for cisplatin administration such as
daily, weekly and 3 week cycles have been proposed.
We compared and analyzed the tumor response, the
overall survival, the toxicity and the chemotherapy dose
intensity in the patients with locally advanced nasopharyngeal
cancer who were treated with CCRT.
Materials and Methods: We performed a retrospective
study on 55 patients with locally advanced nasopharyngeal
cancer, and they were treated with CCRT as a
front-line treatment from Jan 1996 to Jun 2007 at Kangnam
Saint Mary's Hospital.
Results: The patients had a median age of 53 years
(range: 19∼75 years). Of the total 55 patients, a 3-week
cycle of 100mg cisplatin was administered in 31 patients
and 30 mg weekly cisplatin was administered in 24
patients combined with radiotherapy. Twenty one patients
had a complete response and four patients had a
partial response for a response rate of 71.4% (95% CI:
59.5∼83.3) after CCRT and followed by adjuvant
chemotherapy. The complete response rates for the 30 mg and
100 mg cisplatin groups were 72.7% (95% CI: 54.9∼
90.5) and 54.2% (95% CI: 36.7∼71.7), respectively (p=
0.23). The duration of CCRT in the 100mg cisplatin group
was significantly longer than that of the 30mg cisplatin
group (11.1±2.9 weeks vs. 9.0±1.2 weeks, p= 0.003).
The major deviation group, which was defined as prolongation
of the radiotherapy duration for more than 2 weeks,
had a significantly lower objective response rate than did
the non-deviation group (56.3% vs 84.2%, respectively,
p= 0.002). The major severe toxicities were leucopenia
(49.1%), pharyngoesophagitis (49.1%), anorexia (43.6%),
nausea (41.8%) and vomiting (40%).
Conclusions: Weekly 30mg cisplatin-based CCRT is a
practical, feasible cisplatin schedule for the patients with
locally advanced nasopharyngeal cancer in regard to
decreasing the interruption of radiation treatment and
decreasing the treatment-related acute toxicities.*표시는 필수 입력사항입니다.
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도서위치안내: 정기간행물실(524호) / 서가번호: 국내16
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