Chemoradiotherapy Versus Radiotherapy in Patients With Advanced Nasopharyngeal Cancer: Phase III Randomized Intergroup Study 0099
Muhyi Al-Sarraf, Michael LeBlanc, Shanker Giri, et.al.
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001
Reviewers: Li Liu, MD
Source: Journal of Clinical Oncology, Volume 16, No 4 (April), 1998
BackgroundThe nasopharynx is a cubical cavity located behind the nasal cavity and superior to the soft palate. Superiorly it borders the base of skull and floor of the sphenoid sinus.Laterally it is perforated by the eustachian tubes, which connect to internal ears. Nasopharynx is rich in lymphatics. Patients with nasopharyngeal cancer may present withenlarged neck lymph nodes even in the absence of other symptoms.
Nasopharyngeal cancer is a relatively rare disease in the United States, approximately 0.6 to 0.8 per 100,000 population. The highest prevalent is in southern China, withincidence rates as high as 20 per 100,000. The incidence for descendants of southern Chinese living in other countries remains higher than the other population.
Because of the anatomic location of nasopharyngeal cancer, surgical resection of a primary lesion is successful. Radiation therapy (XRT) is considered the treatment ofchoice for the majority of patients with this disease. However, the local control and survival of patients with loco-regionally advanced disease treated with radiation aloneremain unsatisfactory. Some Phase II trials using combination of chemotherapy (CTX) and radiation therapy have shown promising results. This led to the National Headand Neck Cancer Intergroup randomized phase III trial of advanced nasopharyngeal cancer. Southwest Oncology Group (SWOG) with participation of Radiation TherapyOncology Group (RTOG) and Eastern Cooperative Oncology Group (ECOG) coordinated this study.