Meta-Analysis Indicates Improved Survival with Addition of Chemotherapy

Meta-Analysis Indicates Improved Survival with Addition of Chemotherapy in Nasopharyngeal Cancer.

According to results published in the International Journal of Radiation Oncology, Biology and Physics,results from an analysis of several clinical trials indicate that the addition of chemotherapy to radiation therapy improves survival compared to radiation therapy alone for the treatment of locally advanced nasopharyngeal cancer.

The nasopharynx is the area above the soft palate (roof of the mouth) and behind the nose. Nasopharyngeal cancer (NPC) is considered a type of head and neck cancer. Approximately 40,000 people in the U.S. are diagnosed with head and neck cancer every year.

Cancers of the head and neck comprise several types of cancer affecting the nasal cavity, sinuses, oral cavity, nasopharynx, oropharynx, and other sites throughout the head and neck. The American Cancer Society estimates that 11,000 people will die from head and neck cancer in 2005.

Locally advanced NPC refers to cancer that has spread from its site of origin, but not to distant sites in the body. Although standard therapy for locally advanced NPC is radiation therapy, patients may also be treated with chemotherapy. However, in terms of a survival advantage, the addition of chemotherapy to radiation therapy has remained inconclusive among this group of patients.

Researchers from France recently analyzed updated data from eight trials that included 1,753 patients with locally advanced NPC. In these trials, patients were either treated with radiation only, or chemotherapy plus radiation therapy. At a median follow-up of 6 years, patients who received chemotherapy in addition to radiation therapy had improved outcomes compared to those treated with radiation therapy alone.

  • Overall survival was improved among patients treated with chemotherapy/radiation compared to those treated with radiation only (52% versus 42%, respectively).
  • The chemotherapy combination cisplatin (Platinol®) plus 5-FU (fluorouracil) achieved the best results overall (however, this was not consistent in all trials).
  • Chemotherapy administered during the time of radiation therapy also achieved better results than if treatments were administered sequentially.

The researchers concluded that the addition of chemotherapy appears to improve survival when administered with radiation therapy for the treatment of locally advanced NPC. Patients diagnosed with locally advanced NPC may wish to speak with their physician about their individual risks and benefits of treatment including chemotherapy or the participation in a clinical trial further evaluating benefits of different chemotherapy agents or novel therapeutic approaches.

Reference: Baujat B, Audry H, Bourhis J, et al. Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients. International Journal of Radiation Oncology, Biology, Physics. 2005; 64: 47-56.

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