Radiotherapy versus Combined Radiotherapy and Chemotherapy for T4 Nasopharyngeal Carcinoma

T4鼻咽癌：放射治療和放射治療加輔助性化學治療結果的比較

賴允亮(Yuen-Liang Lai) ； 陳俊偉(Robert Tan) ； 劉幕台(Mu-Tai Liu) ； 李必忍(James C. Li)

《中華放射線醫學雜誌》 17卷2期 (1992/06) Pp. 103-107

摘要

From January 1980 to December 1990, a total of 91 patients with T4 nasopharyngeal carcinoma according to 1988 AJCC classification were treated with radiotherapy at the Department of Radiation Oncology. Male to female ratio was 3.5:1. The median age of the population was 54 years with a mean age of 51 years. There were 55 patients treated with radioth. eapy only while 36 patients received both radiotherapy and chemotherapy. All 91 patients were treated wih radiotherapy up to a total dose of 7,000 cGy to the nasopharynx and skull base. Dose given to the neck depended on the neck node status. With N0 status, prophylactic dose of 5,000 cGy was given while for N+ status, curative dose of 7,000 cGy was given. For adjuvant chemotherapy, 36 patients received 4 to 5 courses of combination regimen using Cisplatin (100 mg/m^2 on Day 1) plus continuous infusion of 5. Fluorouracil 1000 mg/m^2 (Day 1 to Day 5). The results showed that 10 T4N0 M0 patients treated with radiotherapy and chemotherapy had a significantly better 5-year survival rate than the corresponding 19 patients treated with radiotherapy only (70% vs. 58%, p=0.05). However, the combined modality showed no benefit on the survival of T4N(superscript +) patients (53% vs. 51%). In terms of local control rate, disregarding the nodal status, the combined modality group got no significant advantage. With regard to distant metastasis, the group treated with radiotherapy only had a slightly higher distant failure rate (22% vs. 17%, p＞0.05).

關鍵字

鼻咽腫瘤 ； 鼻咽放射治療學 ； 化學治療

並列摘要

From January 1980 to December 1990, a total of 91 patients with T4 nasopharyngeal carcinoma according to 1988 AJCC classification were treated with radiotherapy at the Department of Radiation Oncology. Male to female ratio was 3.5:1. The median age of the population was 54 years with a mean age of 51 years. There were 55 patients treated with radioth. eapy only while 36 patients received both radiotherapy and chemotherapy. All 91 patients were treated wih radiotherapy up to a total dose of 7,000 cGy to the nasopharynx and skull base. Dose given to the neck depended on the neck node status. With N0 status, prophylactic dose of 5,000 cGy was given while for N+ status, curative dose of 7,000 cGy was given. For adjuvant chemotherapy, 36 patients received 4 to 5 courses of combination regimen using Cisplatin (100 mg/m^2 on Day 1) plus continuous infusion of 5. Fluorouracil 1000 mg/m^2 (Day 1 to Day 5). The results showed that 10 T4N0 M0 patients treated with radiotherapy and chemotherapy had a significantly better 5-year survival rate than the corresponding 19 patients treated with radiotherapy only (70% vs. 58%, p=0.05). However, the combined modality showed no benefit on the survival of T4N(superscript +) patients (53% vs. 51%). In terms of local control rate, disregarding the nodal status, the combined modality group got no significant advantage. With regard to distant metastasis, the group treated with radiotherapy only had a slightly higher distant failure rate (22% vs. 17%, p＞0.05).

並列關鍵字

nasopharynx, neoplasm ； therapeutic radiology, nasopharynx ； chemotherapy