Induction chemotherapy (CTX) followed by concurrent chemoradiotherapy (CRT) in patients (pts) with nasopharyngeal cancer (NPC)

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 5598-5598
Author(s):  
J.-H. Choi ◽  
H. Y. Lim ◽  
J. S. Park ◽  
H. C. Kim ◽  
S. Kang ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Nasopharyngeal Cancer

Induction chemotherapy (CTX) followed by concurrent chemoradiotherapy (CRT) in patients (pts) with nasopharyngeal cancer (NPC)

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 5598-5598
Author(s):  
J.-H. Choi ◽  
H. Y. Lim ◽  
J. S. Park ◽  
H. C. Kim ◽  
S. Kang ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Nasopharyngeal Cancer

Applying the ASCO and ESMO Value Frameworks to nasopharyngeal cancer treatments: Is adding induction chemotherapy or adjuvant chemotherapy to concurrent chemoradiotherapy worthwhile?

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 67-67
Author(s):  
Teng Hwee Tan ◽  
Yu Yang Soon ◽  
Timothy Cheo ◽  
Lea Choung Wong ◽  
Yiat Horng Leong ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Induction Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Locally Advanced ◽  
Wholesale Price ◽  
Nasopharyngeal Cancer ◽  
Health Benefit ◽  
Concurrent Chemotherapy ◽  
Drug Costs ◽  
Phase Iii

67 Background: To determine and compare the incremental clinical benefit (ICB) and costs of induction chemotherapy (IC) when added to concurrent chemoradiotherapy (CCRT), concurrent chemotherapy (CC) added to RT and CC + adjuvant chemotherapy (AC) when added to RT for locally advanced nasopharyngeal cancer (LA-NPC). Methods: We searched phase III randomized controlled trials (RCTs) which reported overall survival (OS) benefit with the use of IC, CC and CC+AC in LA-NPC. We quantified the ICB using the ASCO and ESMO value framework. We calculated the incremental drug costs in US dollars using the lowest average wholesale price reported in the Lexicomp drug database. Results: We identified three RCTs on IC, three RCTs on CC and four RCTs on CC + AC. The ICB was judged to be Grade A based on the ESMO framework. The ASCO Net Health Benefit Score (NHBS) ranged from 17.43 to 57.39. The incremental drug costs ranged from 133.46 to 626.14. There were no statistically significant differences in the means of NHBS [39.37 (IC) vs 37.61 (CC) vs 33.98 (CC+AC), P = 0.89] and costs [383 (IC) vs 253 (CC) vs 460 (CC+AC), P = 0.27] between these three approaches. There was no statistically significant correlation between ICB and costs. Conclusions: The magnitudes of ICB and incremental drug costs of adding of IC to CCRT, CC to RT and CC + AC to RT for LA NPC are not significantly different.

scholarly journals Pretreatment Plasma EBV-DNA Load Guides Induction Chemotherapy Followed by Concurrent Chemoradiotherapy in Locoregionally Advanced Nasopharyngeal Cancer: A Meta-Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Lin Lai ◽  
Xinyu Chen ◽  
Chuxiao Zhang ◽  
Xishan Chen ◽  
Li Chen ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Meta Analysis ◽  
Nasopharyngeal Cancer ◽  
Progression Free Survival ◽  
Significant Heterogeneity ◽  
Free Survival ◽  
Barr Virus ◽  
Heterogeneity Test ◽  
Ebv Dna

BackgroundThe efficacy of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) in locoregionally advanced nasopharyngeal cancer (LA-NPC) is controversial. In this paper, we conduct a meta-analysis based on relevant studies to provide strong evidence for clinical strategies.Materials and MethodsWe searched the MEDLINE, Embase, Cochrane, PubMed, and Web of Science databases for studies that stratified patients based on a high or low plasma Epstein–Barr virus deoxyribonucleic acid (EBV-DNA) load before treatment and compared the clinical efficacy of IC+CCRT vs. CCRT alone in LA-NPC. We tested for heterogeneity of studies and conducted sensitivity analysis. Subgroup analysis was performed for overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS).ResultsSeven studies with a total of 5289 cases were finally included in the meta-analysis. The heterogeneity test revealed the homogeneity of OS (I2 = 0.0%, p=0.794), PFS (I2 = 0.0%, p=0.778), DMFS (I2 = 0.0%, p=0.997), and LRFS (I2 = 0.0%, p=0.697) in patients with EBV-DNA loads of ≥4000 copies/ml in both the IC+CCRT and CCRT groups. The results reveal that IC+CCRT significantly extended the OS (HR 0.70 [95% CI 0.58-0.83], p=0.000), PFS (HR 0.83 [95% CI 0.70-0.99], p=0.033), and DMFS (HR 0.79 [95% CI 0.69-0.9], p=0.000) of patients compared with the CCRT group, but there were no beneficial effects on LRFS (HR 1.07 [95% CI 0.80-1.42], p=0.647). The heterogeneity test found that there was no significant heterogeneity of PFS (I2 = 0.0%, p=0.564), DMFS (I2 = 0.0%, p=0.648), LRFS (I2 = 22.3%, p=0.257), and OS (I2 = 44.6%, p=0.164) in patients with EBV-DNA loads of <4000 copies/ml. The results show that IC+CCRT prolonged DMFS (HR 0.57 [95% CI 0.39-0.85], p=0.006) of patients without significant improvements in OS (HR 0.88 [95% CI 0.55-1.26], p=0.240), PFS (HR 0.98 [95% CI 0.74-1.31], p=0.908), and LRFS (HR 0.98 [95% CI 0.54-1.77], p=0.943).ConclusionsPretreatment plasma EBV-DNA can be considered a promising effective marker for the use of IC in LA-NPC patients. The addition of IC could improve the OS and PFS of patients with EBV-DNA load ≥4000 copies/ml, but we saw no efficacy in patients with EBV-DNA load <4000 copies/ml. Moreover, regardless of the EBV-DNA load, IC could improve DMFS, but there was no effect on LRFS.

Applying the ASCO and European Society for Medical Oncology Value Frameworks to Nasopharyngeal Cancer Treatments: Is Adding Induction Chemotherapy or Adjuvant Chemotherapy to Concurrent Chemoradiotherapy Worthwhile?

2020 ◽  
Vol 16 (11) ◽  
pp. e1386-e1396
Author(s):  
Teng Hwee Tan ◽  
Yu Yang Soon ◽  
Timothy Cheo ◽  
Lea Choung Wong ◽  
Yiat Horng Leong ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Induction Chemotherapy ◽  
European Society ◽  
Concurrent Chemoradiotherapy ◽  
Medical Oncology ◽  
Locally Advanced ◽  
Nasopharyngeal Cancer ◽  
Health Benefit ◽  
Drug Costs ◽  
Phase Iii

PURPOSE: To determine and compare the incremental clinical benefit (ICB) and costs of induction chemotherapy (IC) when added to concurrent chemoradiotherapy (CCRT), concurrent chemotherapy (CC) when added to radiotherapy (RT), and CC plus adjuvant chemotherapy (AC) when added to RT for locally advanced nasopharyngeal cancer (LA-NPC). MATERIALS AND METHODS: We searched phase III randomized controlled trials (RCTs) that reported overall survival benefit with the use of IC, CC, and CC + AC in LA-NPC. We quantified the ICB using the ASCO and European Society for Medical Oncology (ESMO) value frameworks. We calculated the incremental drug costs in US dollars using the lowest average wholesale price reported in the Lexicomp drug database. RESULTS: We identified three RCTs on IC, three RCTs on CC, and four RCTs on CC + AC. The ICB was judged to be grade A based on the ESMO framework. The ASCO Net Health Benefit score ranged from 17.43 to 57.39. The incremental drug costs ranged from $133.46 to $626.14. There were no statistically significant differences in the mean Net Health Benefit scores (39.37 for IC v 37.61 for CC v 33.98 for CC + AC; P = .89) and costs ($383 for IC v $253 for CC v $460 for CC + AC; P = .27) between the three approaches. There was no statistically significant correlation between ICB and costs. CONCLUSION: The magnitudes of ICB and incremental drug costs of adding of IC to CCRT, CC to RT, and CC + AC to RT for LA-NPC are not significantly different.

scholarly journals Oral findings during follow-up of nasopharyngeal squamous cell carcinoma treatment: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110330
Author(s):  
Atsushi Musha ◽  
Nobuteru Kubo ◽  
Naoko Okano ◽  
Hidemasa Kawamura ◽  
Yuhei Miyasaka ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Concurrent Chemoradiotherapy ◽  
Nasopharyngeal Cancer ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
History Of ◽  
Oral Area

A 50-year-old woman with a long history of nasopharyngeal cancer (T2N2M0, squamous cell carcinoma) underwent chemoradiotherapy and surgery. In the past, to prevent tumor recurrence or metastasis, she underwent concurrent chemoradiotherapy or neck dissection. However, during a follow-up 10 years after the surgery, intense F-18 fluorodeoxyglucose uptake was detected in the oral area (SUVmax 6.0). A biopsy of the area with F-18 fluorodeoxyglucose uptake revealed pathological inflammation. Radiography showed the presence of a wisdom tooth, located at the F-18 fluorodeoxyglucose accumulation site, and pericoronitis of this tooth was detected. Our findings indicate the importance of considering the effect of inflammatory conditions, such as periodontal disease, in using F-18 fluorodeoxyglucose positron emission tomography/computed tomography during follow-up after head and neck cancer treatment.

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