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Journal of Clinical Oncology, Vol 16, 1310-1317, Copyright © 1998 by American Society of Clinical Oncology

ARTICLES

Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099

M Al-Sarraf, M LeBlanc, PG Giri, KK Fu, J Cooper, T Vuong, AA Forastiere, G Adams, WA Sakr, DE Schuller and JF Ensley
Department of Medicine, Providence Cancer Center, Southfield, MI, USA.

PURPOSE: The Southwest Oncology Group (SWOG) coordinated an Intergroup study with the participation of Radiation Therapy Oncology Group (RTOG), and Eastern Cooperative Oncology Group (ECOG). This randomized phase III trial compared chemoradiotherapy versus radiotherapy alone in patients with nasopharyngeal cancers. MATERIALS AND METHODS: Radiotherapy was administered in both arms: 1.8- to 2.0-Gy/d fractions Monday to Friday for 35 to 39 fractions for a total dose of 70 Gy. The investigational arm received chemotherapy with cisplatin 100 mg/m2 on days 1, 22, and 43 during radiotherapy; postradiotherapy, chemotherapy with cisplatin 80 mg/m2 on day 1 and fluorouracil 1,000 mg/m2/d on days 1 to 4 was administered every 4 weeks for three courses. Patients were stratified by tumor stage, nodal stage, performance status, and histology. RESULTS: Of 193 patients registered, 147 (69 radiotherapy and 78 chemoradiotherapy) were eligible for primary analysis for survival and toxicity. The median progression-free survival (PFS) time was 15 months for eligible patients on the radiotherapy arm and was not reached for the chemo-radiotherapy group. The 3-year PFS rate was 24% versus 69%, respectively (P < .001). The median survival time was 34 months for the radiotherapy group and not reached for the chemo- radiotherapy group, and the 3-year survival rate was 47% versus 78%, respectively (P = .005). One hundred eighty-five patients were included in a secondary analysis for survival. The 3-year survival rate for patients randomized to radiotherapy was 46%, and for the chemoradiotherapy group was 76% (P < .001). CONCLUSION: We conclude that chemoradiotherapy is superior to radiotherapy alone for patients with advanced nasopharyngeal cancers with respect to PFS and overall survival.
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[Abstract] [Full Text] [PDF]

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 NEJMHome page
J.-C. Lin, W.-Y. Wang, K. Y. Chen, Y.-H. Wei, W.-M. Liang, J.-S. Jan, and R.-S. Jiang
Quantification of Plasma Epstein-Barr Virus DNA in Patients with Advanced Nasopharyngeal Carcinoma
N. Engl. J. Med., June 10, 2004; 350(24): 2461 - 2470.
[Abstract] [Full Text] [PDF]

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 Arch Otolaryngol Head Neck SurgHome page
Radiology Quiz Case 1--Diagnosis
Arch Otolaryngol Head Neck Surg, June 1, 2004; 130(6): 798 - 799.
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 NEJMHome page
J. S. Cooper, T. F. Pajak, A. A. Forastiere, J. Jacobs, B. H. Campbell, S. B. Saxman, J. A. Kish, H. E. Kim, A. J. Cmelak, M. Rotman, et al.
Postoperative Concurrent Radiotherapy and Chemotherapy for High-Risk Squamous-Cell Carcinoma of the Head and Neck
N. Engl. J. Med., May 6, 2004; 350(19): 1937 - 1944.
[Abstract] [Full Text] [PDF]

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 Ann OncolHome page
E. Ozyar and M. Cengiz
With regard to "Induction chemotherapy followed by concomitant chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal cancer" by Oh et al. (AnnOnc 2003; 14: 564-569)
Ann. Onc., April 1, 2004; 15(4): 689 - 689.
[Full Text] [PDF]

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 JCOHome page
L. Licitra, P. Bossi, L. Locati, and F. Zunino
Cisplatin and Fluorouracil Concurrent to Radiotherapy in Nasopharyngeal Cancer: Is the Schedule Compatible?
J. Clin. Oncol., January 15, 2004; 22(2): 377 - 377.
[Full Text] [PDF]

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 JCOHome page
J.-C. Lin and J.-S. Jan
In Reply:
J. Clin. Oncol., January 15, 2004; 22(2): 377 - 378.
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 JCOHome page
J. M. Unger, M. LeBlanc, J. J. Crowley, H. B. Grossman, R. B. Natale, A. J. Wozniak, J. R. Berenson, A. F. List, W. A. Peters III, R. C. Flanigan, et al.
Estimating the Impact of New Clinical Trial Proven Cancer Therapy and Cancer Chemoprevention on Population Mortality: The Karnofsky Memorial Lecture
J. Clin. Oncol., December 1, 2003; 21(90230): 246s - 252.
[Abstract] [Full Text] [PDF]

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 Jpn J Clin OncolHome page
K. Isobe, H. Kawakami, T. Uno, S. Yasuda, T. Aruga, N. Ueno, T. Kawata, and H. Ito
Concurrent Chemoradiotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma: is Intergroup Study 0099 Feasible in Japanese Patients?
Jpn. J. Clin. Oncol., October 1, 2003; 33(10): 497 - 500.
[Abstract] [Full Text] [PDF]

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M.-T. Liu, C.-Y. Hsieh, T.-H. Chang, J.-P. Lin, C.-C. Huang, and A.-Y. Wang
Prognostic Factors Affecting the Outcome of Nasopharyngeal Carcinoma
Jpn. J. Clin. Oncol., October 1, 2003; 33(10): 501 - 508.
[Abstract] [Full Text] [PDF]

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T. P. Farias, F. L. Dias, R. A. Lima, J. Kligerman, G. M. de Sa, M. M. Barbosa, and F. B. Goncalves Jr
Prognostic Factors and Outcome for Nasopharyngeal Carcinoma
Arch Otolaryngol Head Neck Surg, July 1, 2003; 129(7): 794 - 799.
[Abstract] [Full Text] [PDF]

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 Clin. Cancer Res.Home page
A. A. Makitie, C. MacMillan, J. Ho, W. Shi, A. Lee, B. O'Sullivan, D. Payne, M. Pintilie, B. Cummings, J. Waldron, et al.
Loss of p16 Expression Has Prognostic Significance in Human Nasopharyngeal Carcinoma
Clin. Cancer Res., June 1, 2003; 9(6): 2177 - 2184.
[Abstract] [Full Text] [PDF]

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L. Licitra
Chemoradiation therapy in locally advanced nasopharyngeal cancer: which kind of cooperation?
Ann. Onc., April 1, 2003; 14(4): 508 - 509.
[Full Text] [PDF]

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J. L. Oh, E. E. Vokes, M. S. Kies, B. B. Mittal, M. E. Witt, R. R. Weichselbaum, and D. J. Haraf
Induction chemotherapy followed by concomitant chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal cancer
Ann. Onc., April 1, 2003; 14(4): 564 - 569.
[Abstract] [Full Text] [PDF]

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 JCOHome page
S. C. Formenti, M. Volm, K. A. Skinner, D. Spicer, D. Cohen, E. Perez, A. C. Bettini, S. Groshen, C. Gee, B. Florentine, et al.
Preoperative Twice-Weekly Paclitaxel With Concurrent Radiation Therapy Followed by Surgery and Postoperative Doxorubicin-Based Chemotherapy in Locally Advanced Breast Cancer: A Phase I/II Trial
J. Clin. Oncol., March 1, 2003; 21(5): 864 - 870.
[Abstract] [Full Text] [PDF]

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 JCOHome page
J.-C. Lin, J.-S. Jan, C.-Y. Hsu, W.-M. Liang, R.-S. Jiang, and W.-Y. Wang
Phase III Study of Concurrent Chemoradiotherapy Versus Radiotherapy Alone for Advanced Nasopharyngeal Carcinoma: Positive Effect on Overall and Progression-Free Survival
J. Clin. Oncol., February 15, 2003; 21(4): 631 - 637.
[Abstract] [Full Text] [PDF]

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 The OncologistHome page
R. Haddad, R. B. Tishler, C. M. Norris, A. Mahadevan, P. Busse, L. Wirth, L. A. Goguen, C. A. Sullivan, R. Costello, M. A. Case, et al.
Docetaxel, Cisplatin, 5-Fluorouracil (TPF)-Based Induction Chemotherapy for Head and Neck Cancer and the Case for Sequential, Combined-Modality Treatment
Oncologist, February 1, 2003; 8(1): 35 - 44.
[Abstract] [Full Text] [PDF]

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R. S. Weber, B. A. Berkey, A. Forastiere, J. Cooper, M. Maor, H. Goepfert, W. Morrison, B. Glisson, A. Trotti, J. A. Ridge, et al.
Outcome of Salvage Total Laryngectomy Following Organ Preservation Therapy: The Radiation Therapy Oncology Group Trial 91-11
Arch Otolaryngol Head Neck Surg, January 1, 2003; 129(1): 44 - 49.
[Abstract] [Full Text] [PDF]

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G. H. Yoo, M. P. Piechocki, J. F. Ensley, T. Nguyen, J. Oliver, H. Meng, D. Kewson, T. Y. Shibuya, F. Lonardo, and M. A. Tainsky
Docetaxel Induced Gene Expression Patterns in Head and Neck Squamous Cell Carcinoma Using cDNA Microarray and PowerBlot
Clin. Cancer Res., December 1, 2002; 8(12): 3910 - 3921.
[Abstract] [Full Text] [PDF]

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A. T. C. Chan, Y. M. D. Lo, B. Zee, L. Y. S. Chan, B. B. Y. Ma, S.-F. Leung, F. Mo, M. Lai, S. Ho, D. P. Huang, et al.
Plasma Epstein-Barr Virus DNA and Residual Disease After Radiotherapy for Undifferentiated Nasopharyngeal Carcinoma
J Natl Cancer Inst, November 6, 2002; 94(21): 1614 - 1619.
[Abstract] [Full Text] [PDF]

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M. Machtay, D. I. Rosenthal, D. Hershock, H. Jones, S. Williamson, M. J. Greenberg, G. S. Weinstein, V. M. Aviles, A. A. Chalian, and R. S. Weber
Organ Preservation Therapy Using Induction Plus Concurrent Chemoradiation for Advanced Resectable Oropharyngeal Carcinoma: A University of Pennsylvania Phase II Trial
J. Clin. Oncol., October 1, 2002; 20(19): 3964 - 3971.
[Abstract] [Full Text] [PDF]

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W.-Y. Wang, Y.-C. Chien, J.-S. Jan, C.-M. Chueh, and J.-C. Lin
Consistent Sequence Variation of Epstein-Barr Virus Nuclear Antigen 1 in Primary Tumor and Peripheral Blood Cells of Patients with Nasopharyngeal Carcinoma
Clin. Cancer Res., August 1, 2002; 8(8): 2586 - 2590.
[Abstract] [Full Text] [PDF]

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E. P. Hui, A. T. C. Chan, F. Pezzella, H. Turley, K.-F. To, T. C. W. Poon, B. Zee, F. Mo, P. M. L. Teo, D. P. Huang, et al.
Coexpression of Hypoxia-inducible Factors 1{alpha} and 2{alpha}, Carbonic Anhydrase IX, and Vascular Endothelial Growth Factor in Nasopharyngeal Carcinoma and Relationship to Survival
Clin. Cancer Res., August 1, 2002; 8(8): 2595 - 2604.
[Abstract] [Full Text] [PDF]

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 Ann OncolHome page
C. Monnerat, S. Faivre, S. Temam, J. Bourhis, and E. Raymond
End points for new agents in induction chemotherapy for locally advanced head and neck cancers
Ann. Onc., July 1, 2002; 13(7): 995 - 1006.
[Abstract] [Full Text] [PDF]

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A. T. C. Chan, P. M. L. Teo, and P. J. Johnson
Nasopharyngeal carcinoma
Ann. Onc., July 1, 2002; 13(7): 1007 - 1015.
[Abstract] [Full Text] [PDF]

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S. M. Hahn, E. J. Bernhard, W. Regine, M. Mohiuddin, D. G. Haller, J. P. Stevenson, D. Smith, B. Pramanik, J. Tepper, T. F. DeLaney, et al.
A Phase I Trial of the Farnesyltransferase Inhibitor L-778,123 and Radiotherapy for Locally Advanced Lung and Head and Neck Cancer
Clin. Cancer Res., May 1, 2002; 8(5): 1065 - 1072.
[Abstract] [Full Text] [PDF]

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 JCOHome page
D. Rischin and L. J. Peters
The Local-Regionally Advanced Nasopharyngeal Carcinoma Jigsaw Puzzle: Where Does the Chemotherapy Piece Fit?
J. Clin. Oncol., April 15, 2002; 20(8): 1968 - 1970.
[Full Text] [PDF]

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 JCOHome page
A.T.C. Chan, P.M.L. Teo, R.K. Ngan, T.W. Leung, W.H. Lau, B. Zee, S.F. Leung, F.Y. Cheung, W. Yeo, H.H. Yiu, et al.
Concurrent Chemotherapy-Radiotherapy Compared With Radiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: Progression-Free Survival Analysis of a Phase III Randomized Trial
J. Clin. Oncol., April 15, 2002; 20(8): 2038 - 2044.
[Abstract] [Full Text] [PDF]

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 JCOHome page
D. Rischin, J. Corry, J. Smith, J. Stewart, P. Hughes, and L. Peters
Excellent Disease Control and Survival in Patients With Advanced Nasopharyngeal Cancer Treated With Chemoradiation
J. Clin. Oncol., April 1, 2002; 20(7): 1845 - 1852.
[Abstract] [Full Text] [PDF]

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 Br. J. Radiol.Home page
R F Mould and T H P Tai
Nasopharyngeal carcinoma: treatments and outcomes in the 20th century
Br. J. Radiol., April 1, 2002; 75(892): 307 - 339.
[Abstract] [Full Text] [PDF]

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C.-N. Qian, X. Guo, B. Cao, E. J. Kort, C.-C. Lee, J. Chen, L.-M. Wang, W.-Y. Mai, H.-Q. Min, M.-H. Hong, et al.
Met Protein Expression Level Correlates with Survival in Patients with Late-stage Nasopharyngeal Carcinoma
Cancer Res., January 1, 2002; 62(2): 589 - 596.
[Abstract] [Full Text] [PDF]

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 NEJMHome page
A. Forastiere, W. Koch, A. Trotti, and D. Sidransky
Head and Neck Cancer
N. Engl. J. Med., December 27, 2001; 345(26): 1890 - 1900.
[Full Text] [PDF]

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R.-L. Hong, L.-L. Ting, J.-Y. Ko, M.-M. Hsu, T.-S. Sheen, P.-J. Lou, C.-C. Wang, N.-N. Chung, and L. T. Lui
Induction Chemotherapy With Mitomycin, Epirubicin, Cisplatin, Fluorouracil, and Leucovorin Followed by Radiotherapy in the Treatment of Locoregionally Advanced Nasopharyngeal Carcinoma
J. Clin. Oncol., December 1, 2001; 19(23): 4305 - 4313.
[Abstract] [Full Text]

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N. Fuwa, Y. Ito, T. Kodaira, A. Matsumoto, M. Kamata, K. Furutani, H. Tatibana, M. Sasaoka, and K. Morita
Therapeutic Results of Alternating Chemoradiotherapy for Nasopharyngeal Cancer using Cisplatin and 5-Fluorouracil: Its Usefulness and Controversial Points
Jpn. J. Clin. Oncol., December 1, 2001; 31(12): 589 - 595.
[Abstract] [Full Text] [PDF]

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 JCOHome page
A. Fortin, C. Couture, R. Doucet, M. Albert, J. Allard, and B. Tetu
Does Histologic Grade Have a Role in the Management of Head and Neck Cancers?
J. Clin. Oncol., November 1, 2001; 19(21): 4107 - 4116.
[Abstract] [Full Text] [PDF]

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 Arch Otolaryngol Head Neck SurgHome page
I. Doweck, K. T. Robbins, and F. Vieira
Analysis of Risk Factors Predictive of Distant Failure After Targeted Chemoradiation for Advanced Head and Neck Cancer
Arch Otolaryngol Head Neck Surg, November 1, 2001; 127(11): 1315 - 1318.
[Abstract] [Full Text] [PDF]

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 JCOHome page
W. F. Regine, J. Valentino, S. M. Arnold, R. C. Haydon, D. Sloan, D. Kenady, J. Strottmann, C. Pulmano, and M. Mohiuddin
High-Dose Intra-Arterial Cisplatin Boost With Hyperfractionated Radiation Therapy for Advanced Squamous Cell Carcinoma of the Head and Neck
J. Clin. Oncol., July 15, 2001; 19(14): 3333 - 3339.
[Abstract] [Full Text] [PDF]


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