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Title   진행 비인강암 치료시 유도화학요법과 근치적 방사선요법의 역할 ( The Role of Combined Induction Chemotherapy and Radical Radiation Therapy in the Treatment of Advanced Nasopharyngeal Cancer )
Publicationinfo   1993 Jan; 025(03): 403-416.
Key_word   Nasapharyngeal cancer, Combined therapy, Radiotherapy alone
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Abstract   Background: For patients with locally advanced nasopharyngeal cancer, radiotherapy is the standard treatment but has poor outcome because of frequent loco-regional recurrences and distant metastases. We studied to determine whether the combined induction chemotherapy and radical radiotherapy would improve the survival of such patients. Methods: Patients in the trial had biopsy confirmed previously untreated, locally advanced stage III or IV nasopharyngeal cancer. They were assigned to receive 2-3 cycles of induction chemotherapy consisting of intravenous 5-fluorouracil(I.O gm/m/day for 5 day as a continuous infusion) and cisplatin(100 mg/m on day 1) every 3 weeks followed by radical radiotherapy in six-weeks courses(6000-7500 cGy, 180-200 cGy/day, 5 days/week), or to radiotherapy(up to 7,500 cGy, I80-200 cGy/day, 5 days/week). Results; Of the 58 enrolled patients, 54 patients were evaluable. Between the 23 combined therapy patients and 31 radiotherapy alone patients, the differences of age, sex, performance status, disease stage, and tumor differentiation were not significant statistically. Complete remissions were achievable in 69.6% of the patients in combined therapy group and 74.2% of those in radiotherapy alone group(p=0.323). The 4 year progression free survival was 53.2% in combined therapy group and 54.9% in radiotherapy alone group(P=0.654) The 4 year overall survival was 58.8% and 53.8%, respectively(p=0.209). The side effects of combined therapy were comparable to those of radiotherapy, and there were no episodes of any life threatening toxicities. Conclusion: Although the combined therapy with induction chemotherapy followed by radi- cal radiotherapy did not improve the tumor controls and survivals than radiotherapy alone, but the side effects were comparable in both groups. To improve the tumor controls and survivals in patients with advanced nasopharyngeal cancer, different combined approaches such as concurrent or alternating chemo-radiotherapy is strongly recommended.
저 자   최진혁(Jin Hyuk Choi),노재경(Jae Kyung Roh),임호영(Ho Yeong Lim),정현철(Hyun Cheol Chung),유내춘(Nae Chue Yoo),안신기(Shon Kee Ahn),고은희(Eun Hee Koh),김주항(Joo Hang Kim),서창옥(Chang Ok Suh),김귀언(Gwi Eon Kim),노준규(John Jun Loh),김병수(Byung Soo Kim)