© 2005 Oxford University Press
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Overall Survival After Concurrent Cisplatin–Radiotherapy Compared With Radiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma
Affiliations of authors: Department of Clinical Oncology, Sir Y. K. Pao Center for Cancer, Prince of Wales Hospital, Chinese University of Hong Kong (ATCC, SFL, PMLT, WHK, EPH, WY, KHY, KWC, TSKM, FKFM, MMPL, BBYM, MKMM, TWTL, PJJ, PHKC, BCYZ); Department of Clinical Oncology, Queen Elizabeth Hospital (RKCN, WHL, HYY, FYC, DTC, SY, KTY); Centre for Clinical Trials, School of Public Health, Chinese University of Hong Kong (BCYZ)
Correspondence to: Anthony Tak Cheung Chan, MD, Department of Clinical Oncology, Prince of Wales Hospital, Shatin, N.T. Hong Kong (e-mail: anthonytcchan{at}cuhk.edu.hk).
This phase III randomized study compared concurrent cisplatin–radiotherapy (CRT) versus radiotherapy (RT) alone in patients with locoregionally advanced nasopharyngeal carcinoma. A total of 350 patients were randomly assigned to receive external RT alone or concurrently with cisplatin at a dosage of 40 mg/m2 weekly. The primary endpoint was overall survival, and the median follow-up was 5.5 years. The 5-year overall survival was 58.6% (95% confidence interval [CI] = 50.9% to 66.2%) for the RT arm and 70.3% (95% CI = 63.4% to 77.3%) for the CRT arm. In Cox regression analysis adjusted for T stage, age, and overall stage, the difference in overall survival was statistically significantly in favor of concurrent CRT (P = .049, hazard ratio [HR] = 0.71 [95% CI = 0.5 to 1.0]). Subgroup analysis demonstrated that there was no difference between overall survival in the arms for T1/T2 stage (P = .74, HR = 0.93 [95% CI = 0.59 to 1.4]), whereas there was a difference between the arms for T3/T4 stage (P = .013, HR = 0.51 [95% CI = 0.3 to 0.88]), favoring the CRT arm. The regimen of weekly concurrent CRT is a promising standard treatment strategy for locoregionally advanced nasopharyngeal carcinoma patients.
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