Cargando…
Impact of Neoadjuvant Chemotherapy on the Administration of Concurrent Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma
Objectives The standard of care for locally advanced nasopharyngeal carcinoma (NPC) is concurrent cisplatin chemoradiotherapy. Neoadjuvant chemotherapy can be administered to downsize tumors before concurrent treatment to optimize radiation volumes. Our hypothesis was that the use of cisplatin in th...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166912/ https://www.ncbi.nlm.nih.gov/pubmed/30280053 http://dx.doi.org/10.7759/cureus.2971 |
_version_ | 1783360107425300480 |
---|---|
author | Maas, Benjamin Ho, Cheryl Hamilton, Sarah Leedy, Doug Berthelet, Eric |
author_facet | Maas, Benjamin Ho, Cheryl Hamilton, Sarah Leedy, Doug Berthelet, Eric |
author_sort | Maas, Benjamin |
collection | PubMed |
description | Objectives The standard of care for locally advanced nasopharyngeal carcinoma (NPC) is concurrent cisplatin chemoradiotherapy. Neoadjuvant chemotherapy can be administered to downsize tumors before concurrent treatment to optimize radiation volumes. Our hypothesis was that the use of cisplatin in the neoadjuvant phase could limit the amount of cisplatin that patients could tolerate in the concurrent phase of treatment. Methods This is a retrospective analysis of Canadian NPC patients who received neoadjuvant chemotherapy with the intention to downsize locally advanced tumors prior to concurrent cisplatin plus radiation. Baseline demographic and treatment data were obtained from institutional databases and chart review; all data were analyzed with SPSS (SPSS Inc. Released 2005. SPSS for Windows, Version 14.0. Chicago: SPSS Inc.) Overall survival (OS), disease-specific survival (DSS), and local/regional relapse-free survival (LRRFS) were analyzed using Kaplan-Meier survival functions. Univariate and multivariate models were used to determine factors associated with the total dose of concurrent chemotherapy. Results Forty-six patients were identified as receiving neoadjuvant chemotherapy before concurrent chemoradiotherapy. In the univariate and multivariate analyses of patients who received concurrent chemotherapy, receiving over 200 mg/m(2) concurrent cisplatin with radiation was associated with a higher neoadjuvant dose of chemotherapy received. The median follow-up time was 2.6 years (range, 0.17 years to 10.6 years). At three years, the OS was 83%, DSS was 86%, and LRRFS was 74%. Conclusions NPC patients have been treated with neoadjuvant chemotherapy at this center with favorable outcomes. Most patients could tolerate concurrent chemotherapy after radiotherapy. Receiving higher doses of concurrent chemotherapy was associated with also having higher doses of neoadjuvant cisplatin. This suggests that neoadjuvant cisplatin is not a limiting factor in the delivery of full-dose concurrent chemotherapy. |
format | Online Article Text |
id | pubmed-6166912 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-61669122018-10-02 Impact of Neoadjuvant Chemotherapy on the Administration of Concurrent Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma Maas, Benjamin Ho, Cheryl Hamilton, Sarah Leedy, Doug Berthelet, Eric Cureus Otolaryngology Objectives The standard of care for locally advanced nasopharyngeal carcinoma (NPC) is concurrent cisplatin chemoradiotherapy. Neoadjuvant chemotherapy can be administered to downsize tumors before concurrent treatment to optimize radiation volumes. Our hypothesis was that the use of cisplatin in the neoadjuvant phase could limit the amount of cisplatin that patients could tolerate in the concurrent phase of treatment. Methods This is a retrospective analysis of Canadian NPC patients who received neoadjuvant chemotherapy with the intention to downsize locally advanced tumors prior to concurrent cisplatin plus radiation. Baseline demographic and treatment data were obtained from institutional databases and chart review; all data were analyzed with SPSS (SPSS Inc. Released 2005. SPSS for Windows, Version 14.0. Chicago: SPSS Inc.) Overall survival (OS), disease-specific survival (DSS), and local/regional relapse-free survival (LRRFS) were analyzed using Kaplan-Meier survival functions. Univariate and multivariate models were used to determine factors associated with the total dose of concurrent chemotherapy. Results Forty-six patients were identified as receiving neoadjuvant chemotherapy before concurrent chemoradiotherapy. In the univariate and multivariate analyses of patients who received concurrent chemotherapy, receiving over 200 mg/m(2) concurrent cisplatin with radiation was associated with a higher neoadjuvant dose of chemotherapy received. The median follow-up time was 2.6 years (range, 0.17 years to 10.6 years). At three years, the OS was 83%, DSS was 86%, and LRRFS was 74%. Conclusions NPC patients have been treated with neoadjuvant chemotherapy at this center with favorable outcomes. Most patients could tolerate concurrent chemotherapy after radiotherapy. Receiving higher doses of concurrent chemotherapy was associated with also having higher doses of neoadjuvant cisplatin. This suggests that neoadjuvant cisplatin is not a limiting factor in the delivery of full-dose concurrent chemotherapy. Cureus 2018-07-12 /pmc/articles/PMC6166912/ /pubmed/30280053 http://dx.doi.org/10.7759/cureus.2971 Text en Copyright © 2018, Maas et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Otolaryngology Maas, Benjamin Ho, Cheryl Hamilton, Sarah Leedy, Doug Berthelet, Eric Impact of Neoadjuvant Chemotherapy on the Administration of Concurrent Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma |
title | Impact of Neoadjuvant Chemotherapy on the Administration of Concurrent Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma |
title_full | Impact of Neoadjuvant Chemotherapy on the Administration of Concurrent Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma |
title_fullStr | Impact of Neoadjuvant Chemotherapy on the Administration of Concurrent Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma |
title_full_unstemmed | Impact of Neoadjuvant Chemotherapy on the Administration of Concurrent Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma |
title_short | Impact of Neoadjuvant Chemotherapy on the Administration of Concurrent Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma |
title_sort | impact of neoadjuvant chemotherapy on the administration of concurrent chemoradiation for locally advanced nasopharyngeal carcinoma |
topic | Otolaryngology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166912/ https://www.ncbi.nlm.nih.gov/pubmed/30280053 http://dx.doi.org/10.7759/cureus.2971 |
work_keys_str_mv | AT maasbenjamin impactofneoadjuvantchemotherapyontheadministrationofconcurrentchemoradiationforlocallyadvancednasopharyngealcarcinoma AT hocheryl impactofneoadjuvantchemotherapyontheadministrationofconcurrentchemoradiationforlocallyadvancednasopharyngealcarcinoma AT hamiltonsarah impactofneoadjuvantchemotherapyontheadministrationofconcurrentchemoradiationforlocallyadvancednasopharyngealcarcinoma AT leedydoug impactofneoadjuvantchemotherapyontheadministrationofconcurrentchemoradiationforlocallyadvancednasopharyngealcarcinoma AT bertheleteric impactofneoadjuvantchemotherapyontheadministrationofconcurrentchemoradiationforlocallyadvancednasopharyngealcarcinoma |