benefits of adjuvant chemo after concurrent radio+chemo in NPC

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aluo1271
aluo1271 Member Posts: 25
in Head and Neck Cancer #1
My treatment plan is being put in place except that my radio oncologist and medical oncologist have different opinions on whether I need that follow up cisplatin + FU5, called the adjuvant chemo.

In my case, I was diagnosed as stage 3 NPC (T3N0M0, EBV+) in mid of April. The T3 is because the tumor touches bone structure at base of skull. From PET and CT, no spread was found.

My radio onc, who is a great guy and very experienced in head and neck cancer, proposed concurrent imrt plus chemo, but mentioned that since I don't have any spread, it is a possibility that he could fix it without the follow-up chemo. The benefits is less toxic.

My medical onc whom I also respect very much, thinks that since the standard protocol includes follow-up chemo for my stage, and because the outcome looks good, he thinks that I shouldn't risk not getting it, as long as my body can take it.

The current literature seems to have contradicting results on benefits of adjuvant chemo. There is one report mentioned that it helped prevent remote metastasis, another study report no benefit at all and the increased toxic of adjuvant increases risk of complications of side effects.

I wonder if you have any experiences/advise on this issue. Anyway, I thank you all for the help in pointing me to great doctors and hospitals. I am very fortunate to have found great doctors to treat this.

Comments

  • Kent Cass
    Kent Cass Member Posts: 1,898 Member
    #2
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    NPC
    My NPC showed in 11/08 and started tx in 2/09. Wheras you have an ID'd tumor, I was unknown Primary. All I got was concurrent chemo and rads, and am a success story. The one thing about my tx that was different was the chemo schedule and delivery. Our NPCs are different, so you can't compare.

    If I read you right- you're asking if C overkill with additional chemo is a good idea. Do remember someone citing stats about the benefits of chemo, which probably includes the adjuvant, and I think the factor was a 5% better chance, though that is a generality stat. As a rule, to err is to error on the side of the aggressive with C...

    kcass
  • CherriBlossom
    CherriBlossom Member Posts: 44 Member
    #3
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    I was diagnosed a year ago
    I was diagnosed a year ago with NPC T4N1M0, also ebv positive. Based on my stage, adjuvant chemo w/cisplatin and 5fu is the standard treatment.
  • phrannie51
    phrannie51 Member Posts: 4,716
    #4
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    Here's something I'm grateful for.......
    my Dr.'s are in agreement for my treatment. What a dilemma, if they were disagreeing, and putting that on you to decide!!

    I'm NPC T1N2M0.......I will be getting the adjuvant chemo...and I'd be scared to do it any other way. Just because the nodes didn't light up, doesn't mean a few sneaky little cells didn't get there, just not enough to light up the screen.

    Since it's adjuvant chemo, maybe do a "wait and see"....it's not a decision that has to be made today, that's for sure. I am in favor of agggressive now, in lieu of EVER having to do this all over again...keep my misery to one "rough spot" in the road...not drag it out. But that's me, and that's the treatment I was prescribed...and everybody agrees on it....phew!

    p
  • osmotar
    osmotar Member Posts: 1,006
    #5
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    Treatment
    My ticket was punched for the full ride; 1 all day session every 21 days of cisplatin/toxetore/5fu pump mon thru fri all comp Oct 2011. Nov 1st started 7.5 weeks mon-fri of rads along with 1 weekly infusion of carboplstin. All went well with minimum side effects-both my chemo onco and rad doc work for the same group so each knew what the other was doing.....would I do it again yes I would. I was diagnosed with stage4 tonsil cancer that went to 1 lymph node...so far I have had 1 PET that was ned and2 throat scopes by my ent that show all good. In the end it's your treatment and your decision, you can only rely on your docs recommendatios.

    Linda
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #6
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    Cisplatin, Taxotere & 5FU
    Nine weeks of that and an additional seven weeks of concurrent weekly Carboplatin and 35 daily rads...

    That was for Tonsil Cancer though, STGIII SCC HPV+ and also a lymphnode.

    For me, I think I'd rather let my chemo MD handle the chemo, and have the rads MD stick to his/her specialty.

    Anyways, for me, I'd rather be more aggressive than needed, rather than not aggressive enough.

    Besides, rads are the harder of treatment, with more long tern effects.

    Best,
    John
  • aluo1271
    aluo1271 Member Posts: 25
    #7
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    osmotar said:

    Treatment
    My ticket was punched for the full ride; 1 all day session every 21 days of cisplatin/toxetore/5fu pump mon thru fri all comp Oct 2011. Nov 1st started 7.5 weeks mon-fri of rads along with 1 weekly infusion of carboplstin. All went well with minimum side effects-both my chemo onco and rad doc work for the same group so each knew what the other was doing.....would I do it again yes I would. I was diagnosed with stage4 tonsil cancer that went to 1 lymph node...so far I have had 1 PET that was ned and2 throat scopes by my ent that show all good. In the end it's your treatment and your decision, you can only rely on your docs recommendatios.

    Linda

    Thank you all for the comments
    I've come to see maybe the additional toxicity from adjvant chemo is marginal compared with the total. Well in this case it's an easy choice.

    Time flies fast, during the last month, I rose from the shock of diagnose, to the stress of searching for doctors, meanwhile did 3 ct, 2 mri, 1 pet and 1 surgery (biopsy), carrying imaging CDs and reports running around... I have to say that I've come to met the doctors that are truly amazing, not only world class in expertise, but also with so much caring. That's where my trust come from.
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    #8
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    aluo1271 said:

    Thank you all for the comments
    I've come to see maybe the additional toxicity from adjvant chemo is marginal compared with the total. Well in this case it's an easy choice.

    Time flies fast, during the last month, I rose from the shock of diagnose, to the stress of searching for doctors, meanwhile did 3 ct, 2 mri, 1 pet and 1 surgery (biopsy), carrying imaging CDs and reports running around... I have to say that I've come to met the doctors that are truly amazing, not only world class in expertise, but also with so much caring. That's where my trust come from.

    3 ct, 2 mri, 1 pet and 1 surgery
    And a Partridge in a Pear Tree.....

    It's definitely a learning experience.....

    When I first learned that I had cancer, I thought of pale, frail no color, no hair people, that eventually withered up and died.... Boy am I happy to be wrong...actually I was far from the truth.

    Technology, history, experience, modern medicine and great MD's totally have taken cancer treantment and survival to a place far exceeding the days of my childhood.

    I rarely knew any survivors....

    Today, I are one....LOL

    JG
  • aluo1271
    aluo1271 Member Posts: 25
    #9
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    Skiffin16 said:

    3 ct, 2 mri, 1 pet and 1 surgery
    And a Partridge in a Pear Tree.....

    It's definitely a learning experience.....

    When I first learned that I had cancer, I thought of pale, frail no color, no hair people, that eventually withered up and died.... Boy am I happy to be wrong...actually I was far from the truth.

    Technology, history, experience, modern medicine and great MD's totally have taken cancer treantment and survival to a place far exceeding the days of my childhood.

    I rarely knew any survivors....

    Today, I are one....LOL

    JG

    have faith
    You are such a fighter! Thanks for the encouragement. Indeed we are in good hands now, have faith and keep fighting. Time is in our favor.

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