passages: 654
passages: document
passages: Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma : positive effect on overall and progression-free survival . PURPOSE Nasopharyngeal carcinoma ( NPC ) is a radiosensitive and chemosensitive tumor . This randomized phase III trial compared concurrent chemoradiotherapy ( CCRT ) versus radiotherapy ( RT ) alone in patients with advanced NPC . PATIENTS AND METHODS From December 1993 to April 1999 , 284 patients with 1992 American Joint Committee on Cancer stage III to IV ( M0 ) NPC were randomly allocated into two arms . Similar dosage and fractionation of RT was administered in both arms . The investigational arm received two cycles of concurrent chemotherapy with cisplatin 20 mg/m ( 2 ) /d plus fluorouracil 400 mg/m ( 2 ) /d by 96-hour continuous infusion during the weeks 1 and 5 of RT . Survival analysis was estimated by the Kaplan-Meier method and compared by the log-rank test . RESULTS Baseline patient characteristics were comparable in both arms . After a median follow-up of 65 months , 26.2 % ( 37 of 141 ) and 46.2 % ( 66 of 143 ) of patients developed tumor relapse in the CCRT and RT-alone groups , respectively . The 5-year overall survival rates were 72.3 % for the CCRT arm and 54.2 % for the RT-only arm ( P =.0022 ) . The 5-year progression-free survival rates were 71.6 % for the CCRT group compared with 53.0 % for the RT-only group ( P =.0012 ) . Although significantly more toxicity was noted in the CCRT arm , including leukopenia and emesis , compliance with the combined treatment was good . The second cycle of concurrent chemotherapy was refused by nine patients and was delayed for > or = 1 week for another nine patients . There were no treatment-related deaths in either arm . CONCLUSION We conclude that CCRT is superior to RT alone for patients with advanced NPC in endemic areas .
entities: 655
entities: Intervention_Pharmacological
entities: concurrent chemoradiotherapy
entities: 656
entities: Intervention_Physical
entities: radiotherapy
entities: 657
entities: Intervention_Pharmacological
entities: concurrent chemoradiotherapy ( CCRT )
entities: 658
entities: Intervention_Physical
entities: radiotherapy ( RT )
entities: 659
entities: Intervention_Pharmacological
entities: chemotherapy
entities: 660
entities: Intervention_Pharmacological
entities: cisplatin
entities: 661
entities: Intervention_Pharmacological
entities: fluorouracil
entities: 662
entities: Intervention_Pharmacological
entities: CCRT
entities: 663
entities: Intervention_Physical
entities: RT-alone
entities: 664
entities: Intervention_Pharmacological
entities: CCRT
entities: 665
entities: Intervention_Physical
entities: RT-only
entities: 666
entities: Intervention_Pharmacological
entities: CCRT
entities: 667
entities: Intervention_Physical
entities: RT-only
entities: 668
entities: Intervention_Pharmacological
entities: CCRT
entities: 669
entities: Intervention_Pharmacological
entities: CCRT
entities: 670
entities: Intervention_Physical
entities: RT
entities: 671
entities: Outcome_Mortality
entities: overall and progression-free survival .
entities: 672
entities: Outcome_Mortality
entities: Survival analysis
entities: 673
entities: Outcome_Physical
entities: tumor relapse
entities: 674
entities: Outcome_Mortality
entities: 5-year overall survival rates
entities: 675
entities: Outcome_Mortality
entities: 5-year progression-free survival rates
entities: 676
entities: Outcome_Adverse-effects
entities: toxicity
entities: 677
entities: Outcome_Adverse-effects
entities: leukopenia
entities: 678
entities: Outcome_Adverse-effects
entities: emesis
entities: 679
entities: Outcome_Mortality
entities: treatment-related deaths
entities: 680
entities: Participant_Condition
entities: advanced nasopharyngeal carcinoma :
entities: 681
entities: Participant_Condition
entities: patients with advanced NPC .
entities: 682
entities: Participant_Condition
entities: From December 1993 to April 1999
entities: 683
entities: Participant_Sample-size
entities: 284
entities: 684
entities: Participant_Condition
entities: patients with 1992 American Joint Committee on Cancer stage III to IV ( M0 ) NPC
entities: 685
entities: Participant_Condition
entities: patients with advanced NPC