Final results of a randomized phase III trial of induction chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in patients with stage IVA and IVB nasopharyngeal carcinoma-Taiwan Cooperative Oncology Group (TCOG) 1303 Study

Annals of Oncology : Official Journal of the European Society for Medical Oncology
R L HongT W Liu

Abstract

Concurrent chemoradiotherapy (CCRT) is superior to radiotherapy alone for treating locoregionally advanced nasopharyngeal carcinoma (NPC). Whether adding induction chemotherapy (IC) further improves the outcome warrants investigation. This open-label multicenter phase III trial was conducted at 11 institutions in Taiwan. Patients with stage IVA or IVB NPC were randomized to receive IC followed by CCRT (I-CCRT) or CCRT alone. Patients in the I-CCRT arm received three cycles of mitomycin C, epirubicin, cisplatin, and 5-fluorouracil/leucovorin (MEPFL). All patients received 30 mg/m2 cisplatin weekly during radiotherapy, which was delivered as 1.8-2.2 Gy per fraction with five daily fractions per week, to a total dose of 70 Gy or greater to the primary tumor and 66-70 Gy to the involved neck. The primary end point was disease-free survival (DFS). In this study, 240 and 239 patients were randomized to CCRT and I-CCRT arm, respectively. The most prominent toxicities of induction were leukopenia (grade 3 and 4: 47% and 12%) and thrombocytopenia (grade 3 and 4: 24% and 3%). During radiotherapy, severe mucositis was the major side-effect in both arms; an increased number of patients in the I-CCRT arm had myelosuppression; hence, discont...Continue Reading

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Citations

Jun 1, 2019·The New England Journal of Medicine·Yuan ZhangJun Ma
Sep 26, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Carlos Rodriguez-GalindoAlberto S Pappo
Mar 20, 2020·American Society of Clinical Oncology Educational Book·Brigette B Y MaJun Ma
Mar 17, 2020·Current Opinion in Oncology·Edwin Pun HuiAnthony T C Chan
Jul 24, 2020·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Min TangJu Zhang
May 22, 2019·The British Journal of Radiology·Liang PengJun Ma
Jul 1, 2020·Frontiers in Oncology·Lachlan McDowellDanny Rischin
Mar 27, 2020·Frontiers in Oncology·Xiaojiao ZengYirong Li
Jan 3, 2021·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Shan Li, Liangfang Shen
Jan 7, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Yu-Pei ChenJun Ma
Oct 15, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Diana D Shi, Harvey J Mamon
Jan 26, 2021·Frontiers in Oncology·Shan-Shan YangFang-Yun Xie
Feb 15, 2021·Critical Reviews in Oncology/hematology·Alberto BongiovanniToni Ibrahim
Sep 15, 2020·The Oncologist·Maïmouna ManéDirk Van Gestel
Feb 19, 2021·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Lucheng FangXingwang Rao
Mar 10, 2021·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Yu-Yu DuanYan He
Jul 2, 2021·Nature Reviews. Clinical Oncology·Kenneth C W WongAnthony T C Chan
Jul 15, 2021·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Min TangJu Zhang
May 23, 2021·Journal of the National Cancer Institute·Mengyun Qiang, Xing Lv

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