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AI InsightA retrospective analysis of 32 locally advanced nasopharyngeal carcinoma patients treated with chemotherapy and radiotherapy
📌 3 Maddede Bu Makale
Özet
A retrospective analysis of 32 locally advanced nasopharyngeal carcinoma patients treated with chemotherapy and radiotherapy
Abstract
To analyze the impact of neoadjuvant chemotherapy on the treatment of locoregionally advanced nasopharyngeal carcinoma and to assess the outcomes of patients receiving such treatment, we analyzed 32 cases that have been treated with neoadjuvant chemotherapy followed by radiotherapy and adjuvant chemotherapy retrospectively at GATA Military Medical School between 1996-2000. Out of 32 cases, 27 were male, 5 were female (sex ratio 5.4:1 respectively). Median age was 25 (19-64). 15.62% of the cases were Stage III and 84.37% were stage IVA-B. 20 cases had undifferentiated carcinoma, 9 cases had squamous cell carcinoma (SCC), 2 cases had anaplastic carcinoma and one case had lymphoepithelioma as histopathologic diagnosis. All cases were given one of the following chemotherapy regimes for 2-3 cycles; Cisplatin + 5-fluorouracil + Bleomycin, Cisplatin + Ifosfamide + Mesna + Bleomycin and Cisplatin + Adriamycin + Bleomycin. Following chemotherapy 66-70 Gy radiotherapy was delivered to every patient using Co-60 teleradiotherapy machine. After the radiotherapy, patients had received 3 to 4 cycles of chemotherapy. The objective response rate was 96.87%, complete response rate was 40.62%, partial response rate was 56.25% and no-response rate was 3.12%. Three-year overall cumulative survival rate was 48.11% while disease free survival rate was 43.75%. Complication rates due to chemotherapy were mucositis (grade l 6.25%, grade II 6.25%, grade III 3.12%), myelosuppression (grade II 21.87%, grade III 3.12%, grade IV 6.25%) and nausea (grade l 3.12%) whilst radiotherapy-related complication rates were; mucositis (grade l 6.25%, grade II 15.62%, grade III 6.25%), dysphagia (grade l 6.25%, grade II 6.25%), nausea (grade l 3.12%) and fibrosis of skin (grade II 6.25%). While not providing conclusive evidence, historical data of our institution suggest that addition of chemotherapy to Standard radiotherapy improves survival despite increasing the toxicity of the treatment.