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