Weekly paclitaxel with concurrent radiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma

Hu, Wei; Ding, Weijun; Yang, Haihua; Shao, Minghai; Wang, Biyun; Wang, Jianhua; Wu, Sufang; Wu, Shixiu; Jin, Lihui; Ma, Charlie C.-M.

doi:10.1016/j.radonc.2009.06.030

« Previous Next »Radiotherapy & Oncology
Volume 93, Issue 3 , Pages 488-491, December 2009

Weekly paclitaxel with concurrent radiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma

Wei Hu
- Radiation Oncology Department, Taizhou Hospital, Wenzhou Medical College, Taizhou, China
- Corresponding author. Address: Radiation Oncology Department, Taizhou Hospital of Zhejiang Province, 150 Ximen, Linhai, Zhejiang Province 317000, China.
Weijun Ding
- Radiation Oncology Department, Taizhou Hospital, Wenzhou Medical College, Taizhou, China
Haihua Yang
- Radiation Oncology Department, Taizhou Hospital, Wenzhou Medical College, Taizhou, China
Minghai Shao
- Radiation Oncology Department, Taizhou Hospital, Wenzhou Medical College, Taizhou, China
Biyun Wang
- Radiation Oncology Department, Taizhou Hospital, Wenzhou Medical College, Taizhou, China
Jianhua Wang
- Radiation Oncology Department, Taizhou Hospital, Wenzhou Medical College, Taizhou, China
Sufang Wu
- Radiation Oncology Department, Taizhou Hospital, Wenzhou Medical College, Taizhou, China
Shixiu Wu
- Radiation Oncology Department, The First Affiliated Hospital, Wenzhou Medical College, Wenzhou, China
Lihui Jin
- Radiation Oncology Department, Fox Chase Cancer Center, Philadelphia, PA, USA
Charlie C.-M. Ma
- Radiation Oncology Department, Fox Chase Cancer Center, Philadelphia, PA, USA

Received 28 November 2008; received in revised form 9 June 2009; accepted 27 June 2009. published online 13 August 2009.

Abstract

Purpose

To evaluate the efficacy and toxicity of weekly paclitaxel with concurrent radiotherapy followed by adjuvant chemotherapy (AC) in patients with locally advanced nasopharyngeal carcinoma (NPC).

Methods and materials

Between 2004 and 2007, 54 patients with locally advanced NPC were included in this protocol. Patient characteristics: median age 48; 69% male; 52% World Health Organization (WHO) III; 50% stage III, 50% stage IV. The patients underwent a course of definitive conventional radiotherapy (70Gy in 7weeks with 2Gy/fraction), with concurrent weekly paclitaxel 35mg/m² from the first to the sixth week of radiation. AC was started 4weeks after the end of the radiotherapy (RT), paclitaxel 135mg/m² on day 1 and cisplatin 30mg/m² on days 1–3 were administered every 4weeks for two cycles.

Results

Median follow-up was 32months. Eighty-five percentage of complete response and 15% partial response were achieved at the time of one month after AC. The 3-year actuarial rate of local regional control was 86%; distant metastases-free survival, progression-free survival and overall survival at 3years were 81%, 69% and 76%, respectively. Forty-nine (91%) patients completed six courses of concurrent chemotherapy with weekly paclitaxel, and 4 (7%) patients delayed at the second cycle of AC. No patient developed severe acute toxicities.

Conclusions

Weekly paclitaxel with concurrent RT followed by AC is a potentially effective and toxicity tolerable method for locally advanced NPC. Further studies are needed to identify the optimal dose of weekly paclitaxel in this strategy.

Keywords: Chemoradiotherapy, Nasopharyngeal carcinoma, Locally advanced