奈达铂每周方案同期适形放疗治疗局部晚期鼻咽癌的临床研究

目的：探讨周剂量奈达铂化疗同步适形放疗治疗局部晚期鼻咽癌的疗效及不良反应。方法：81例局部晚期鼻咽癌患者,随机分为奈达铂同期适形放疗组（CRT组）和单纯适形放疗组（RT组）。RT组患者仅行适形放疗,CRT组患者在适形放疗的基础上加用奈达铂。观察两组患者的近期疗效、远期疗效和不良反应。结果：鼻咽部肿块残存率：CRT组为12.2%（5/41）,RT组为20.0%（8/40）;颈部肿块残存率：CRT组为17.1%（7/41）,RT组为37.5%（15/40）,CRT组明显低于RT组（P〈0.05）;CRT组和RT组1、3年生存率分别为92.7%（38/41）、75.6%（31/41）和92.5%（37/40）、70.0%（28/40）（P〉0.05）。不良反应主要表现为白细胞减少和Ⅲ度口腔黏膜反应。结论：小剂量奈达铂每周化疗同步放疗可提高局部晚期鼻咽癌颈淋巴消除率,其不良反应可接受。     

奈达铂每周方案同期放疗治疗老年局部晚期鼻咽癌的疗效观察

目的探讨奈达铂每周方案同期放疗治疗老年晚期鼻咽癌的疗效和不良反应。方法将100例老年局部晚期鼻咽癌患者随机分为单纯放疗组和同期放化疗组。前者行单纯放疗,后者行奈达铂每周同期放疗。观察2组患者的近期疗效、远期疗效和不良反应。结果单纯放疗组(RT)和同期放化疗组(CRT)3个月后,鼻咽部肿块残存率分别为18.00%(9/50)和16.00%(8/50),差异无统计学意义(P>0.05);颈部肿块残存率分别为18.00%(9/50)和8.00%(4/50),单纯放疗组明显高于同期放化疗组,差异有统计学意义(P<0.05)。单纯放疗组(RT)和同期放化疗组(CRT)的1年生存率分别为92.00%和94.00%,4年生存率分别为70.00%和76.00%,差异均无统计学意义(P>0.05)。2组患者均有不同程度的口腔黏膜损伤,肠胃不良反应和白细胞减少。结论采用奈达铂每周同期放疗可提高老年局部晚期鼻咽癌的疗效,且毒性可控,患者可以耐受。     

放疗同步HP方案化疗治疗局部晚期鼻咽癌的临床研究

[目的]探讨顺铂 羟基喜树碱同步放疗治疗局部晚期鼻咽癌的疗效及毒副反应.[方法]93例局部晚期鼻咽癌患者,随机分为以顺铂 羟基喜树碱化疗的同期放化疗组(CRT)和单纯放疗组(RT),两组均采用60Co-γ线或加速器照射,鼻咽部Dr68Gy～78Gy/7～8W,颈部DT50Gy～74Gy/5～8W,CRT组于放疗第1天起同时采用顺铂 羟基喜树碱化疗.[结果]放疗后颈部肿块残存率CRT组为14.9%,RT组为37.0%(P＜0.05).CRT组3、5年生存率分别为76.7%、57.4%;RT组分别为47.8%、30.4%,两组差异有显著性(P＜0.05).鼻咽部3年复发率CRT组为8.5%,RT组为30.4%,颈部复发率CRT组为6.4%,RT组为26.1%.3年远处转移率CRT组为14.9%,而RT组为47.8%,两组差异有非常显著性(P＜0.01).两组毒副反应差异无显著性.[结论]顺铂联合羟基喜树碱化疗同步放疗治疗局部晚期鼻咽癌可提高患者的局部控制率和生存率,毒副反应患者可耐受.     

紫杉醇和奈达铂诱导化疗联合同期放化疗治疗晚期鼻咽癌的疗效观察

目的探讨紫杉醇和奈达铂诱导化疗联合同期放化疗治疗局部晚期鼻咽癌的临床疗效。方法 90例中晚期局部鼻咽癌患者随机均分为两组,对照组患者给予放疗加同期化疗方案,观察组患者给予紫杉醇加奈达铂诱导化疗方案,两组患者放疗均采用调强适形放射治疗(IMRT)方式。比较两组患者患者不良反应和1、2年生存率。结果两组患者主要不良反应差异无统计学意义(P>0.05),观察组1年和2年控制率和无远处转移率显著高于对照组,差异有统计学意义(P<0.05),两组患者1、2年生存率差异无统计学意义(P>0.05)。结论紫杉醇+奈达铂诱导化疗联合同期放化疗可有效提高晚期局部鼻咽癌患者的局部控制率及无远处转移率,其不良反应可耐受,值得临床推广。     

奈达铂化疗同步放疗治疗局部晚期鼻咽癌45例

[目的]探讨奈达铂化疗同步放疗治疗局部晚期鼻咽癌的疗效和不良反应。[方法]84例局部晚期鼻咽癌患者,随机分为奈达铂组（45例）和顺铂组（39例）,两组在根治性放疗的同时给予奈达铂（奈达铂100mg/m^2静滴d1、22、43）或顺铂（顺铂100mg/m^2,静滴d1、22、43）化疗。[结果]奈达铂组CR42例（93.3%）,PR3例（6.7%）,顺铂组CR35例（89.7%）,PR4例（10.3%）,两组疗效差异无显著性（P〉0.05）。奈达铂组和顺铂组胃肠道反应发生率分别为22.2%和46.2%,差异有显著性（P〈0.05）,两组骨髓抑制、肝、肾功能损害、皮肤黏膜反应发生率差异均无统计学意义（P〉0.05）。[结论]奈达铂化疗同步放疗治疗局部晚期鼻咽癌疗效确切,不良反应可耐受。     

顺铂与奈达铂同期放化疗治疗局部晚期鼻咽癌的疗效对比

目的探讨顺铂与奈达铂同期放化疗治疗局部晚期鼻咽癌的疗效对比。方法选取2011年1月至2013年12月间江西省肿瘤医院收治的312例局部晚期鼻咽癌患者,根据化疗方案不同分为顺铂组178例和奈达铂组134例。两组患者均采用同期放化疗治疗,顺铂组患者给予顺铂化疗,奈达铂组患者给予奈达铂化疗,对比两组患者近期疗效、2年生存率、2年复发率及不良反应。结果顺铂组患者总有效率为94.4%(168/178),2年生存率为85.4%(152/178),无进展生存率为82.0%(146/178),复发率为12.4%(22/178),转移率为16.3%(29/178);奈达铂组患者总有效率为94.0%(126/134),2年生存率为86.6%(116/134),无进展生存率为82.8%(111/134),复发率为12.7%(17/134),转移率为16.4%(22/134)。两组患者总有效率、2年生存率及复发转移率比较,差异无统计学意义(P>0.05);两组患者不良反应症状基本相同,但奈达铂组患者胃肠道和口腔黏膜反应均明显低于顺铂组,差异均有统计学意义(均P<0.05)。结论顺铂与奈达铂在局部晚期鼻咽癌患者同期放化疗治疗中,近期疗效相近,但奈达铂能有效减轻不良反应,值得临床推广。     

复发鼻咽癌再程适形放疗联合周剂量奈达铂化疗的临床疗效分析

目的探讨再程三维适形放射治疗(3-dimensional conformal radiotherapy,3D-CRT)联合周剂量奈达铂化疗治疗局部复发鼻咽癌患者的临床疗效。方法 47例经首程根治性放射治疗后局部复发的鼻咽癌患者,全部采用三维适形放射治疗,处方剂量:DT 56～66 Gy,28～33次,6～7周;同时采用奈达铂进行化疗:25 mg/m~2,静脉滴注,每周1次,共4～6次。结果全部病例均随访至2011年12月底。近期有效率为87.2%(41/47);1、2年生存率分别为91.5%(43/47)、78.7%(37/47);1、2年局部控制率分别为83.0%(39/47)、66.0%(31/47)。放化疗的毒副反应均能耐受。结论再程三维适形放疗联合周剂量奈达铂化疗治疗局部复发鼻咽癌能够取得较为满意的近期疗效及1、2年生存率。     

三维适形放疗同步奈达铂化疗治疗食管癌的近期疗效观察

目的-观察奈达铂(NDP)同步三维适形放疗治疗中晚期食管癌的临床疗效和不良反应。方法43例经过病理组织学诊断为中晚期食管鳞状细胞癌的患者进行三维适形放疗,总剂量DT(60～66)Gy/(30～33)次,同期每周给予奈达铂单药化疗,NDP 40mg/m²。结果 41例患者可评价疗效和不良反应。随访至放疗后3月,9例CR,20例PR,有效率为70. 7%。主要剂量限制性毒性为骨髓抑制和放射性食管炎。结论 三维适形放射治疗同步奈达铂化疗能明显提高食管癌的近期疗效,且不良反应可耐受。     

局部晚期鼻咽癌同步时辰放、化疗的近期疗效观察

目的:观察局部晚期鼻咽癌同步时辰放、化疗及后程三维适形放疗的肿瘤局部控制率和不良反应的发生情况.方法:2005年8月-2007年8月共纳入67例局部晚期鼻咽癌患者(Ⅲ～ⅣA),常规放疗40 Gy后行鼻咽病灶后程三维适形放疗30 Gy.整个放疗过程中同步时辰给予顺铂、氟尿嘧啶和亚叶酸钙化疗,观察患者的近期疗效和不良反应.结果:1例患者因发生Ⅳ级口腔黏膜炎而放弃同步放、化疗.放疗结束后3个月内,66例患者中无一例发生放疗野内的肿瘤复发,其中鼻咽部肿瘤和颈部病灶达完全缓解者49例(74.2%),部分缓解15例(22.7%),疾病稳定2例(3.0%),无一例患者发生疾病进展.治疗有效率达97.0%.不良反应均可耐受.结论:同步时辰放、化疗及后程三维适形放疗治疗局部晚期鼻咽癌的近期疗效令人满意,且不良反应基本可以耐受.     

三维适形调强放疗同步奈达铂化疗联合尼妥珠单抗靶向治疗鼻咽癌患者的疗效

目的探讨三维适形调强放疗同步奈达铂化疗联合尼妥珠单抗靶向治疗鼻咽癌的临床疗效。方法选取2017年1月至2018年1月间广东医科大学附属医院收治的68例鼻咽癌患者,根据治疗方式不同分为观察组和对照组,每组34例。对照组患者采用三维适形调强放疗同步奈达铂化疗治疗,观察组患者在对照组基础上联合尼妥珠单抗靶向治疗,比较两组患者的临床疗效及不良反应发生情况。结果随访9个月后,观察组患者总有效率为79. 4%,高于对照组的55. 9%,差异有统计学意义(P <0. 05)。两组患者的不良反应发生情况比较,差异均无统计学意义(均P> 0. 05)。结论三维适形调强放疗同步奈达铂化疗联合尼妥珠单抗靶向治疗鼻咽癌患者的近期疗效、安全性及耐受性均良好,值得临床运用。     

Preliminary results of a prospective randomized trial comparing concurrent chemoradiotherapy plus adjuvant chemotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma in endemic regions of china

PURPOSE: A prospective randomized trial was performed to evaluate the efficacy of concurrent chemotherapy and adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) in endemic regions of China. METHODS AND MATERIALS: Between July 2002 and September 2005, 316 eligible patients were randomly assigned to receive either radiotherapy alone (RT) or chemoradiotherapy concurrent with adjuvant chemotherapy (CRT). All patients received 70 Gy in 7 weeks using standard RT portals and techniques. The CRT patients were given concurrent cisplatin (40 mg/m(2) on Day 1) weekly during RT, followed by cisplatin (80 mg/m(2) on Day 1) and fluorouracil (800 mg/m(2) on Days 1-5) every 4 weeks (Weeks 5, 9, and 13) for three cycles after completion of RT. All patients were analyzed by intent-to-treat analysis. RESULTS: The two groups were well-balanced in all prognostic factors and RT parameters. The CRT group experienced significantly more acute toxicity (62.6% vs. 32%, p = 0.000). A total of 107 patients (68%) and 97 patients (61%) completed all cycles of concurrent chemotherapy and adjuvant chemotherapy, with a median follow-up time of 29 months. The 2-year overall survival rate, failure-free survival rate, distant failure-free survival rate, and locoregional failure-free survival rate for the CRT and RT groups were 89.8% vs. 79.7% (p = 0.003), 84.6% vs. 72.5% (p = 0.001), 86.5% vs. 78.7% (p = 0.024), and 98.0% vs. 91.9% (p = 0.007), respectively. CONCLUSIONS: This trial demonstrated the significant survival benefits of concurrent chemotherapy plus adjuvant chemotherapy in patients with locoregionally advanced NPC in endemic regions of China.     

放疗同步TNF方案治疗鼻咽癌的临床疗效观察

目的:观察放疗同期紫杉醇+奈达伯+氟尿嘧啶化疗治疗鼻咽癌的疗效及毒副反应。方法:81例确诊为鼻咽癌的患者随机分为治疗组(放疗同期TNF方案化疗组)41例和对照组(单纯放疗组)40例。治疗组在放射治疗的第1、4周给予TNF方案化疗及放疗后2个周期紫杉醇+奈达伯+氟尿嘧啶方案化疗。结果:治疗组1、3年生存率分别为100%(41/41)、82.9%(34/41)。对照组1、3年生存率分别为87.5%(35/40)、62.5%(25/40) (P＞0.05)。放化组3年生存率及局控率、远处转移控制率明显高于单纯放疗组,治疗组虽消化道反应及骨髓功能抑制明显较对照组发生率高,但与对照组相比无统计学差异。结论:放疗同期TNF化疗治疗鼻咽癌疗效好,毒副反应可耐受。     

Concomitant chemoirradiation for stage III-IV nasopharyngeal carcinoma in Chinese patients: results of a matched cohort analysis

PURPOSE: To evaluate the toxicity and efficacy of concomitant chemoirradiation (CRT) followed by adjuvant chemotherapy compared with radiotherapy (RT) alone in Chinese patients with locoregionally advanced nasopharyngeal carcinoma (NPC). METHODS AND MATERIALS: Between March 1997 and September 2000, 47 Chinese patients with Stage III (n = 9, 19%) and IV (n = 38, 81%) NPC were treated with by CRT using cisplatin 100 mg/m(2) on Days 1, 22, and 43 of RT, plus adjuvant chemotherapy using cisplatin 80 mg/m(2) for 1 day and 5-fluorouracil 1 g/m(2) for 4 days on Days 71, 99, and 127. These patients were then compared with a cohort of 47 patients treated between 1990 and 1993 with RT alone, who were matched with respect to T stage, N stage, nodal bilaterality, nodal level, and nodal size. The RT techniques were similar in the two groups but different dose and fractionation schemes were used. The median biologic equivalent dose to 2 Gy per fraction delivered to the nasopharynx was 68 Gy in the CRT group and 65.3 Gy in the RT-alone group. RESULTS: The compliance rates were 62% for concomitant chemotherapy and 40% for adjuvant chemotherapy. No treatment-related deaths occurred. At the end of treatment, 96% of the CRT group and 79% of the RT-alone group achieved a complete response (p = 0.013). With a median follow-up of 26 months, the 3-year relapse-free survival, disease-specific survival, overall survival, local relapse-free survival, nodal relapse-free survival, and distant metastasis-free survival rate for the CRT group and the RT-alone group was 62% vs. 44% (p = 0.048), 67% vs. 71% (p = 0.88), 65% vs. 69% (p = 0.93), 87% vs. 75% (p = 0.059), 95% vs. 80% (p = 0.026), and 75% vs. 70% (p = 0.84), respectively. CONCLUSION: Our experience indicates that concomitant CRT improves locoregional control in Chinese patients with locoregionally advanced NPC, but our analyses failed to detect any impact on distant failure and survival. The failure to reduce distant metastasis and improve survival may have related in part to the more advanced disease stage in our patients and the relatively low compliance rate of adjuvant chemotherapy. Our findings suggest caution should be exercised in extrapolating the findings of the Intergroup Study 0099 to Chinese patients, and confirmatory results from prospective randomized studies in the endemic population are needed.     

A phase III study of adjuvant chemotherapy in advanced nasopharyngeal carcinoma patients

To evaluate the role of adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma (NPC) patients, we conducted a randomized Phase III trial comparing radiotherapy (RT) followed by adjuvant chemotherapy to RT alone in patients with advanced NPC.

Between November 1994 and March 1999, 157 patients with Stage IV, M₀ (UICC/AJCC, 1992) advanced NPC disease were randomized to receive standard radiotherapy, as follows: 35–40 fractions, 1.8–2.0 Gy/fraction/day, 5 days/week, to a total dose 70–72 Gy with or without 9 weekly cycles of 24-h infusional chemotherapy (20 mg/m² cisplatin, 2,200 mg/m² 5-fluorouracil, and 120 mg/m² leucovorin) after RT. Of 157 patients enrolled, 154 (77 radiotherapy, 77 combined therapy) were evaluable for survival and toxicity analysis.

With a median follow-up of 49.5 months, the 5-year overall survival and relapse-free survival rates were 60.5% vs. 54.5% (p = 0.5) and 49.5% vs. 54.4% (p = 0.38) for the radiotherapy-alone group and the combined radiotherapy and adjuvant chemotherapy group, respectively. The Cox regression showed that the hazard rates ratio of combined treatment to RT alone was 0.673 (p VALUE = 0.232); the 95% confidence interval was 0.352 and 1.288, respectively. Patients who received combined treatment had a lower systemic relapse rate than radiotherapy-alone patients, according to relapse pattern analysis. The incidence of leukopenia (≥ Grade 3) occurred in 17 out of 819 (2.1%) cycles of weekly chemotherapy. No patient developed moderate to severe mucositis (≥ Grade 3).

We conclude that adjuvant chemotherapy after RT for patients with advanced NPC has no benefit for overall survival or relapse-free survival.     

T3T4期鼻咽癌两种推量放疗的近期疗效分析

目的探讨伽玛刀和三维适形放疗推量放疗治疗局部晚期鼻咽癌的近期疗效。方法选择局部晚期（Lrr4期）鼻咽癌患者120例,随机进入伽玛刀推量组（伽玛刀组）40例、3D．CRT推量组（3D—CRT组）40例、调强放射治疗（IMRT）组40例。IMRT组患者采用IMRT技术,鼻咽部大体肿瘤靶区（GTVnx）和其临床靶区（CTVI）的处方剂量分别为76Gy～78Gy和64Gy;颈部转移淋巴结（GTVnd）和其临床靶区（CTV2）的处方剂量分别为64Gy-72Gy和60Gy。伽玛刀组和3D—CRT组患者接受相同方式的常规外照射,鼻咽部剂量为70Gy,针对鼻咽原发灶进行推量治疗,研究组用伽玛刀推量治疗6Gy-10Gy,对照组用3D—CRT推量治疗6Gy～10Gy。结果放疗后3个月和6个月的肿瘤完全消退率与推量方式有关系,差异有统计学意义（P〈0．05、P〈0．01）,伽玛刀组明显优于IM-RT组和3D—CRT组;口干、放射性外耳炎、失眠等放疗急性不良反应与推量方式有关系,差异有统计学意义（P〈0．01）,IMRT组的放疗急性不良反应明显低于伽玛刀组和3D—CRT组;伽玛刀组的放射性外耳炎和失眠的发生率分别为15．0％和12．5％,明显低于3D—CRT组的35．0％和37．5％,其差异有统计学意义（P〈0．05、P〈0．01）。结论常规放疗＋伽玛刀推量治疗局部晚期鼻咽癌可以提高肿瘤完全消退率,有可能提高局部控制率,减少放射治疗的并发症。     

顺铂加长春酰胺配合外照射治疗晚期鼻咽癌的临床研究

目的 观察放化综合治疗晚期鼻咽癌的疗效,方法 ６４例Ｎ２￣Ｎ３晚期鼻咽癌患者随机分为综合组（放疗＋化疗）和单纯放疗组,综合组放疗前后采用化疗方案;顺铂３０ｍｇ／日,连续５天,长春酰胺（Ｖｉｎｄｅｓｉｎｅ,西艾克,ＶＤＳ）３ｍｇ／ｍ＾２,第１天,第７天,两组放疗方法,剂量相同。结果综合组,单纯放疗组在放疗４０Ｇｙ和放疗结束后３个月,颈淋巴结消退率分别为４３．８％、８７．５％和２８．１％、７５．０％（     

Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma

This phase III randomized study compared concurrent cisplatin-radiotherapy (CRT) versus radiotherapy (RT) alone in patients with locoregionally advanced nasopharyngeal carcinoma. A total of 350 patients were randomly assigned to receive external RT alone or concurrently with cisplatin at a dosage of 40 mg/m(2) weekly. The primary endpoint was overall survival, and the median follow-up was 5.5 years. The 5-year overall survival was 58.6% (95% confidence interval [CI] = 50.9% to 66.2%) for the RT arm and 70.3% (95% CI = 63.4% to 77.3%) for the CRT arm. In Cox regression analysis adjusted for T stage, age, and overall stage, the difference in overall survival was statistically significantly in favor of concurrent CRT (P = .049, hazard ratio [HR] = 0.71 [95% CI = 0.5 to 1.0]). Subgroup analysis demonstrated that there was no difference between overall survival in the arms for T1/T2 stage (P = .74, HR = 0.93 [95% CI = 0.59 to 1.4]), whereas there was a difference between the arms for T3/T4 stage (P = .013, HR = 0.51 [95% CI = 0.3 to 0.88]), favoring the CRT arm. The regimen of weekly concurrent CRT is a promising standard treatment strategy for locoregionally advanced nasopharyngeal carcinoma patients.     

周剂量奈达铂同步三维适形放射治疗局部中晚期食管癌的疗效观察

目的：探讨周剂量奈达铂化疗同步放射治疗局部中晚期食管癌的疗效及不良反应.方法：90例局部中晚期食管癌患者,随机分为奈达铂同步放疗组（R＋C组）和单纯适形放疗组（R组）.R组患者仅接受适形放疗,总量（60-70） Gy/（6-7）w,R＋C组患者在放疗的基础上加用奈达铂,每周30mg/m2一次,连续6-7周.观察两组患者的近期疗效、远期疗效和不良反应.结果：R＋C组完全缓解率（CR） 55.6％,R组CR33.3％,两组比较差异有统计学意义（P＜0.05）.1年、2年、3年生存率R＋C组分别为77.8％ （35/45）、44.4％ （20/45）、37.8％ （17/45）,R组分别为66.7％ （30/45）、31.1％ （14/45）、22.2％（10/45）,两组比较差异无统计学意义（P＞0.05）.放化组发生急性消化道反应、白细胞减少和血小板减少,稍高于单放组,多数为Ⅰ-Ⅱ级.结论：周剂量奈达铂同步放射治疗局部中晚期食管癌有较好的疗效,不良反应小,易耐受,方便门诊治疗,值得临床推广应用.     

Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial.

PURPOSE: Nasopharyngeal carcinoma (NPC) is highly sensitive to both radiotherapy (RT) and chemotherapy. This randomized phase III trial compared concurrent cisplatin-RT (CRT) with RT alone in patients with locoregionally advanced NPC. PATIENTS AND METHODS: Patients with Ho's N2 or N3 stage or N1 stage with nodal size > or = 4 cm were randomized to receive cisplatin 40 mg/m(2) weekly up to 8 weeks concurrently with radical RT (CRT) or RT alone. The primary end point was progression-free survival (PFS). RESULTS: Three hundred fifty eligible patients were randomized. Baseline patient characteristics were comparable in both arms. There were significantly more toxicities, including mucositis, myelosuppression, and weight loss in the CRT arm. There were no treatment-related deaths in the CRT arm, and one patient died during treatment in the RT-alone arm. At a median follow-up of 2.71 years, the 2-year PFS was 76% in the CRT arm and 69% in the RT-alone arm (P =.10) with a hazards ratio of 1.367 (95% confidence interval [CI], 0.93 to 2.00). The treatment effect had a significant covariate interaction with tumor stage, and a subgroup analysis demonstrated a highly significant difference in favor of the CRT arm in Ho's stage T3 (P =.0075) with a hazards ratio of 2.328 (95% CI, 1.26 to 4.28). For T3 stage, the time to first distant failure was statistically significantly different in favor of the CRT arm (P =.016). CONCLUSION: Concurrent CRT is well tolerated in patients with advanced NPC in endemic areas. Although PFS was not significantly different between the concurrent CRT arm and the RT-alone arm in the overall comparison, PFS was significantly prolonged in patients with advanced tumor and node stages.