Decubitus Chest & Abdomen

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    A phase III investigation has revealed that radiation and chemotherapy combined considerably improved the 5-year overall survival of individuals with stage II nasopharyngeal carcinoma (NPC: cancer of the passageway between the nose and throat). The study is published November 4 in the Journal of the National Cancer Institute.

    NPC is prevalent in Southeast Asia and Southern China, where radiotherapy (RT) has been the main treatment. While concurrent chemo-radiotherapy (CCRT) is recommended by the National Comprehensive Cancer Network (NCCN), there is insufficient evidence regarding its efficacy, and this has not been defined as an initial endpoint in phase III trials.

    Qui-Yan Chen, M.D., Ph.D., of the Sun Yat-sen University Cancer Center in the People’s Republic of China, and colleagues, conducted a phase III trial in order to find out if combined chemotherapy and radiotherapy confers survival benefit to individuals with stage II NPC. The researchers randomly assigned participants into two groups, 114 patients received radiation therapy while 116 patients received combined chemotherapy and radiation.

    After a median follow-up of 60 months, the researchers discovered that 22.8% of participants in the radiation group had disease progression, in comparison to 11.2% in the combined chemotherapy and radiation group. In addition they found that 5-year overall survival, distant metastasis-free survival and progression-free survival were statistically considerably higher in the combined chemotherapy and radiation group than the radiation group.

    Based on the results from this study, which according to the authors is the first phase III trial to compare RT and CCRT, they conclude that the NCCN guidelines are reasonable. They speculate that early-stage disease might have a smaller distant tumor bulk, and therefore concurrent chemo-radiotherapy might be more effective in destroying distant micro-metastases. Even though participants who received combined chemotherapy and radiation experienced more toxic adverse effects than individuals in the radiation group, the treatment was overall well tolerated when the dose of the chemotherapy drug was reduced.

    Chen et al explain:

    “In summary, we think that the optimal choice for early-stage NPC is cisplatin, at a weekly dose of 30 mg/m2, for both an optimal chemotherapy effect to eradicate small distant tumors and to ensure NPC patient compliance.”

    Written by Grace Rattue
    Copyright: Medical News Today

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