1
|
Ohara K, Takahara M, Kumai T, Yamashina M, Kishibe K, Katada A, Hayashi T. Treatment outcomes of alternating chemoradiotherapy for nasopharyngeal carcinoma: a single-center safety and efficacy study. Braz J Otorhinolaryngol 2022; 89:440-446. [PMID: 36682990 PMCID: PMC10164767 DOI: 10.1016/j.bjorl.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/19/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of Alternating Chemoradiotherapy (ACRT) using cisplatin and 5-Fluorouracil (5-FU) in patients with nasopharyngeal carcinoma. METHODS This was a retrospective study in which patients' clinical records were reviewed to identify patients with a new diagnosis of nasopharyngeal carcinoma at our institution between January 2005 and January 2019. Thirty-seven eligible patients were identified; of these, the clinical details of 27 patients treated with ACRT were evaluated. Patient outcomes, including overall survival and progression-free survival, and adverse events were assessed. RESULTS Of these initial 37 patients, 1, 10, 13, 10, and 3 were staged as I, II, III, IVA, and IVB, respectively, as defined by the 8th edition of the TNM classification system. Twenty-seven patients received ACRT comprising sequential administration of chemotherapy, radiotherapy (wide field), chemotherapy, radiotherapy (shrinking field), and chemotherapy. The 5-year overall survival and progression-free survival rates were 83.7% and 88.9%, respectively. Treatment compliance was 93%, which is comparable to that of previous reports. CONCLUSION ACRT using cisplating and 5-fluorouracil was well tolerated with acceptable efficacy. LEVEL OF EVIDENCE IVa.
Collapse
Affiliation(s)
- Kenzo Ohara
- Asahikawa Medical University, Department of Otolaryngology-Head and Neck Surgery, Asahikawa, Japan.
| | - Miki Takahara
- Asahikawa Medical University, Department of Otolaryngology-Head and Neck Surgery, Asahikawa, Japan
| | - Takumi Kumai
- Asahikawa Medical University, Department of Otolaryngology-Head and Neck Surgery, Asahikawa, Japan; Asahikawa Medical University, Department of Innovative Head & Neck Cancer Research and Treatment (IHNCRT), Asahikawa, Japan
| | - Masaaki Yamashina
- Asahikawa Medical University, Department of Radiology, Asahikawa, Japan
| | - Kan Kishibe
- Asahikawa Medical University, Department of Otolaryngology-Head and Neck Surgery, Asahikawa, Japan
| | - Akihiro Katada
- Asahikawa Medical University, Department of Otolaryngology-Head and Neck Surgery, Asahikawa, Japan
| | - Tatsuya Hayashi
- Asahikawa Medical University, Department of Otolaryngology-Head and Neck Surgery, Asahikawa, Japan
| |
Collapse
|
2
|
SAIJOH S, MATSUZUKA T, SATO H, SUZUKI M, IKEDA M, SUZUKI R, NAKAEGAWA Y, OMORI K. Long-term outcomes of alternating chemoradiotherapy in patients with advanced nasopharyngeal cancer: a single-centre experience over the last decade. Acta Otorhinolaryngol Ital 2018; 38:103-108. [PMID: 29967557 PMCID: PMC6028817 DOI: 10.14639/0392-100x-1835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/01/2017] [Indexed: 11/23/2022]
Abstract
SUMMARY We assessed the long-term outcomes of alternating chemoradiotherapy (ACRT) using 5-fluorouracil and cisplatin (FP) in 25 patients with stage II or advanced nasopharyngeal cancer treated at our institution between April 1999 and April 2010. Median follow-up duration was 87 months (range 2-189). According to the 2009 TNM classification (UICC), six patients were in stage II, nine in stage III, and 10 in stage IV. Treatment completion, response and five-year survival rates were retrospectively assessed. ACRT was performed with a first course of chemotherapy administered followed by the initial round of radiotherapy (36 Gy). Then, a second course of chemotherapy with additional radiotherapy (20-30 Gy) was administered, followed by a final third course of chemotherapy. For chemotherapy, 5-fluorouracil (5-FU, 800 mg/m2/24 h) was intravenously administered for five days, and cisplatin (CDDP, 50 mg/m2/24 h) was administered on the last two days. Treatment completion rate was 96% (24 of 25 cases), and the response rate was 100% (CR: 24 cases and PR: 1 case). Additionally, the five-year overall survival rate was 89.3%. We have demonstrated that ACRT is an effective regimen to treat nasopharyngeal cancer, revealing higher treatment completion, response, and five-year overall survival rates compared with other combinatorial radiotherapy and chemotherapy treatment regimens.
Collapse
Affiliation(s)
- S. SAIJOH
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - T. MATSUZUKA
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - H. SATO
- Department of Radiation Oncology, Fukushima Medical University, Fukushima, Japan
| | - M. SUZUKI
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - M. IKEDA
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - R. SUZUKI
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - Y. NAKAEGAWA
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - K. OMORI
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| |
Collapse
|
3
|
Nakanishi Y, Wakisaka N, Kondo S, Endo K, Sugimoto H, Hatano M, Ueno T, Ishikawa K, Yoshizaki T. Progression of understanding for the role of Epstein-Barr virus and management of nasopharyngeal carcinoma. Cancer Metastasis Rev 2017; 36:435-447. [PMID: 28819752 PMCID: PMC5613035 DOI: 10.1007/s10555-017-9693-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Nasopharyngeal carcinoma (NPC) is very common in southern China and Southeast Asia. In regions where NPC is endemic, undifferentiated subtypes constitute most cases and are invariably associated with Epstein-Barr virus (EBV) infection, whereas the differentiated subtype is more common in other parts of the world. Undifferentiated NPC is a unique malignancy with regard to its epidemiology, etiology, and clinical presentation. Clinically, NPC is highly invasive and metastatic, but sensitive to both chemotherapy and radiotherapy (RT). Overall prognosis has dramatically improved over the past three decades because of advances in management, including the improvement of RT technology, the broader application of chemotherapy, and more accurate disease staging. Despite the excellent local control with modern RT, distant failure remains a challenging problem. Advances in molecular technology have helped to elucidate the molecular pathogenesis of NPC. This article reviews the contribution of EBV gene products to NPC pathogenesis and the current management of NPC.
Collapse
Affiliation(s)
- Yosuke Nakanishi
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan
| | - Naohiro Wakisaka
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan
| | - Satoru Kondo
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan
| | - Kazuhira Endo
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan
| | - Hisashi Sugimoto
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan
| | - Miyako Hatano
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan
| | - Takayoshi Ueno
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan
| | - Kazuya Ishikawa
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan
| | - Tomokazu Yoshizaki
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8640, Japan.
| |
Collapse
|
4
|
Takada A, Nakamura T, Takayama K, Makita C, Suzuki M, Azami Y, Kato T, Tsukiyama I, Hareyama M, Kikuchi Y, Daimon T, Toyomasu Y, Ii N, Nomoto Y, Sakuma H, Fuwa N. Preliminary treatment results of proton beam therapy with chemoradiotherapy for stage I-III esophageal cancer. Cancer Med 2016; 5:506-15. [PMID: 26806272 PMCID: PMC4799947 DOI: 10.1002/cam4.607] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 10/22/2015] [Accepted: 11/17/2015] [Indexed: 12/20/2022] Open
Abstract
The effect of proton beam therapy (PBT) on various cancers is controversial. We aimed to evaluate the efficacy and safety of PBT with alternating chemoradiotherapy (ACRT) for patients with stage I–III esophageal cancer. Two cycles of systemic chemotherapy with a continuous infusion of 5‐fluorouracil (5‐FU) on days 1–5 and a 5h infusion of nedaplatin (NDP) on day 6 were accompanied by thoracic irradiation using X‐ray therapy and PBT. During the first half of the treatment, X‐rays were delivered to the prophylactic area. During the second half of the treatment, proton beams were used to irradiate the involved field. To reduce the dose of cardiac irradiation, proton beams were delivered with posterior and posterior oblique angles. Between January 2009 and December 2012, 47 patients were enrolled in this study. The median follow‐up duration was 29 months for all patients and 40 months for survivors. The 3 year overall survival rate, progression‐free survival rate, and local control rate were 59.2%, 56.3%, and 69.8%, respectively. With respect to grade 3–4 late toxicities, there were no pleural or pericardial effusions, but two patients (4.3%) had esophageal stenosis, one patient (2.1%) had fistula, and two patients (4.3%) developed radiation pneumonitis. PBT with ACRT might have the potential to reduce the risk of cardiac damage and might become one of the primary methods of esophageal cancer treatment.
Collapse
Affiliation(s)
- Akinori Takada
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Tatsuya Nakamura
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Kanako Takayama
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan.,Department of Dentistry/oral surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama, Japan
| | - Chiyoko Makita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya, Japan
| | - Motohisa Suzuki
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Yusuke Azami
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Takahiro Kato
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Iwao Tsukiyama
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Masato Hareyama
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Yasuhiro Kikuchi
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Takashi Daimon
- Division of Biostatistics, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Yutaka Toyomasu
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Noriko Ii
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Yoshihito Nomoto
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Hajime Sakuma
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Nobukazu Fuwa
- Hyogo Ion Beam Medical Center, Shingu, Tatsuno, Hyogo, Japan
| |
Collapse
|