Head and Neck Cancer
PD 10 - H&N 2 - Head and Neck Poster Discussion
1085 - IMRT Combined With Concurrent S-1 Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma: A Prospective Phase II Study
Tuesday, October 23
1:24 PM - 1:30 PM
Location: Room 217 A/B
IMRT Combined With Concurrent S-1 Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma: A Prospective Phase II Study
T. Lv1, X. WANG2, and Y. Wang3; 1Department of radiation oncology, Fudan University ,Shanghai Cancer Center, Shanghai, China, 2Department of Oncology, Fudan University ,Shanghai Medical College, Shanghai, China, 3Department of radiation oncology, Fudan University, Shanghai Cancer Center, Shanghai, China
Purpose/Objective(s): Intensity modulated radiation therapy (IMRT) combined with concurrent cisplatin chemotherapy is the standard treatment modality for locally advanced nasopharyngeal cancer (NPC). However, some patients can not tolerate cisplatin associated toxicities such as nephrotoxicity, ototoxicity, severe nausea and vomitting, and hematological toxicity. S-1 was reported to decrease the above mentioned toxicities during concurrent chemoradiation (CCRT) in non-small cell lung cancer. Up to date, knowledge is lacking regarding the combination of S1 and IMRT for NPC. So we carried out this prospective study to explore the toxicities and efficacy of concurrent IMRT and S1 for those NPC patients who can not tolerate cisplatin chemotherapy.
Materials/Methods: From March 2012 to January 2017,133 patients were enrolled into this study. Among those patients, 101 received two cycles of induction chemotherapy with docetaxel and cisplatin, but had severe nausea and vomitting; the rest 32 patients were aged more than 70. IMRT dose prescription was as follows: 66-70.4Gy to GTV, 57-60.8Gy to CTV1, 54-56Gy to CTV2, given in 30-32 fractions. During the course of IMRT, S1 was given by oral administration at 40mg bid everyday without interruption. Toxicities were recorded every week during treatment and toxicities with the highest grade was included in the final analysis.
Results: Toxicities during CCRT were as follows: leucopenia, grade 0(66.2%), grade 1(21.8%), grade 2(11.3%), grade3(0.7%). Anemia, grade0(63.2%), grade1(35.3%), grade2(1.5%). Thrombocytopenia, grade0(74.4%), grade1(24.1%), grade2(1.5%). Mucositis, grade 1 (9.0%), grade 2 (60.9%), and grade 3 (30.1%). Vomitting, grade 0 (28.1%),grade 1 (63.9%), grade 2 (9.0%). No patients were found to have hepatic and renal toxicity during CCRT. With a median follow-up of 38 months, the three-year local control rate and distant metastasis-free survival rate was 92.2% and 83.4%, respectively.
Conclusion: IMRT and concurrent S1 chemotherapy were well tolerated for locally advanced NPC. Three-year local control rate and distant metastasis-free survival rate was similar to cisplatin-based studies.
Author Disclosure: T.-. Lv: None.