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Induction Chemotherapy Followed by Chemo-intensity-modulated Radiotherapy for Locally Advanced Nasopharyngeal Cancer

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Miah, A. B., Bhide, S. A., Del Rosario, L., Matthews, J., Nicol, R., Tanay, M. A., Gupta, S., Zaidi, S. H., Newbold, K. L., Harrington, K. J., Nutting, C. M. (2016) Induction Chemotherapy Followed by Chemo-intensity-modulated Radiotherapy for Locally Advanced Nasopharyngeal Cancer. CLINICAL ONCOLOGY, 28 (8). E61-E67. ISSN 0936-6555

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Abstract

Aims: To determine the toxicity and tumour control rates after chemo-intensity-modulated radiotherapy (chemo-IMRT) for locally advanced nasopharyngeal cancers (LA-NPC). Materials and methods: Patients with LA-NPC were enrolled in a trial to receive induction chemotherapy followed by parotid-sparing chemo-IMRT. The primary site and involved nodal levels received 65 Gy in 30 fractions and at risk nodal levels received 54 Gy in 30 fractions. Incidence of >= grade 2 subjective xerostomia was the primary end point. Secondary end points included incidences of acute and late toxicities and survival outcomes. Results: Forty-two patients with American Joint Committee on Cancer stages II (12%), III (26%) and IV (62%) (World Health Organization subtype: I [5%]; II [40%]; III [55%]) completed treatment between January 2006 and April 2010 with a median follow-up of 32 months. Incidences of >= grade 2 acute toxicities were: dysphagia 83%; xerostomia 76%; mucositis 97%; pain 76%; fatigue 99% and ototoxicity 12%. At 12 months, >= grade 2 subjective xerostomia was observed in 31%, ototoxicitiy in 13% and dysphagia in 4%. Two year locoregional control was 86.2% (95% confidence interval: 70.0-94.0) with 2 year progression-free survival at 78.4% (61.4e88.6) and 2 year overall survival at 85.9% (69.3-93.9). Conclusions: Chemo-IMRT for LA-NPC is feasible with good survival outcomes. At 1 year, 31% experience >= grade 2 subjective xerostomia. (C) 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Item Type: Article
Authors (ICR Faculty only): Harrington, Kevin and Nutting, Chris
All Authors: Miah, A. B., Bhide, S. A., Del Rosario, L., Matthews, J., Nicol, R., Tanay, M. A., Gupta, S., Zaidi, S. H., Newbold, K. L., Harrington, K. J., Nutting, C. M.
Additional Information: ISI Document Delivery No.: DQ9YP Times Cited: 0 Cited Reference Count: 22 Miah, A. B. Bhide, S. A. Del Rosario, L. Matthews, J. Nicol, R. Tanay, M. A. Gupta, S. Zaidi, S. H. Newbold, K. L. Harrington, K. J. Nutting, C. M. Cancer Research UK, Section of Radiotherapy grant [C46/A2131]; Head and Neck Program [C7224/A13407]; NHS This analysis was funded by Cancer Research UK, Section of Radiotherapy grant number C46/A2131 and Head and Neck Program grant number C7224/A13407. We acknowledge NHS funding to the NIHR Biomedical Research Centre at The Royal Marsden Hospital. 0 ELSEVIER SCIENCE LONDON LONDON CLIN ONCOL-UK
Uncontrolled Keywords: Chemoradiotherapy IMRT nasopharyngeal cancer radiotherapy sequential RADIATION-THERAPY CARCINOMA EXPERIENCE TOXICITY FATIGUE UPDATE TRIAL
Research teams: ICR divisions > Cancer Biology > Targeted Therapy
ICR divisions > Radiotherapy and Imaging > Targeted Therapy

Clinical Units > Head & Neck Cancer Unit
Depositing User: Barry Jenkins
Date Deposited: 10 Aug 2016 09:20
Last Modified: 11 Aug 2016 08:37
URI: http://publications.icr.ac.uk/id/eprint/15241

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