NPC with adjuvant therapy

BarryChen1010
BarryChen1010 Member Posts: 27
in Head and Neck Cancer #1

I was diagnosized with NPC stage IV on July and still in treatment. My family and I was shocked and thanks to God I found this site and noticed a lot of NPC servivors. I got motivated to fight this desease!

I have a question need you help. My medical oncologist suggested cocurrent chemotherapy but without adjuvant chemo. This makes me  worry about the treatment effeciency. The reason she gave is from some Chinese research that adjuvant therapy doesn't help a lot. Did anyone else take treatment without Adjuvant therapy? What's your opinion on this? Thanks.

Pray for everyone who are suffering this pain!

Comments

  • corleone
    corleone Member Posts: 312 Member
    #2
    Maybe. Maybe not.

    This seems to be uncertain. See this article

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370638/

    The conclusion is: “Since we did not find sufficient data to support significant survival in 3-year OS, LRFS, FFS, and DMFS, whether Adjuvant cisplatin or nedaplatin and 5-fluorouracil chemotherapy should be routinely added to residual nasopharyngeal carcinoma patients after undergoing CCRT remain uncertain.”

    However, by checking the Kaplan-Meier survival plots it seems there is a marginal benefit.

     

    Personally, I had the adjuvant therapy, and – while no-one will ever know if I benefited or not - I don’t regret.

  • BarryChen1010
    BarryChen1010 Member Posts: 27
    #3
    corleone said:

    Maybe. Maybe not.

    This seems to be uncertain. See this article

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370638/

    The conclusion is: “Since we did not find sufficient data to support significant survival in 3-year OS, LRFS, FFS, and DMFS, whether Adjuvant cisplatin or nedaplatin and 5-fluorouracil chemotherapy should be routinely added to residual nasopharyngeal carcinoma patients after undergoing CCRT remain uncertain.”

    However, by checking the Kaplan-Meier survival plots it seems there is a marginal benefit.

     

    Personally, I had the adjuvant therapy, and – while no-one will ever know if I benefited or not - I don’t regret.

    Thanks for the quick reply

    Thanks for the quick reply Corleone! I also don't want to regret in the future.

    Was the adjuvant chemo easy for you to tolerant?

  • corleone
    corleone Member Posts: 312 Member
    #4
    BarryChen1010 said:

    Thanks for the quick reply

    Thanks for the quick reply Corleone! I also don't want to regret in the future.

    Was the adjuvant chemo easy for you to tolerant?

    Relatively easy, but need to consider that I had carboplatin (instead of cisplatin which was too toxic for ears, I lost 50% of hearing on the high frequency sound range), and 5FU. Carboplatin was easily tolerated, but 5FU is a pain in … wherever you want to say, because you have to carry a small pump for 5 days and nights with you (the infusion needs to be continuous, because the half-life of 5FU is very short), every month (3 rounds, over 3 months). Small pump, but I also had to carry the 1 liter bag with chemo. Others experienced this very differently, some had bad reaction to 5FU, other with cisplatin/carboplatin. Again, in my case, in terms of side effects was tolerable.

  • Barbaraek
    Barbaraek Member Posts: 626
    #5
    Tried but could not tolerate adjuvant

    Barry, my husband had 35 radiation treatments with 2 concurrent Cisplatin chemotherapy at weeks 1 and 4. The plan was then to do 3 adjuvant chemo treatments of Cisplatin and 5FU, but he was so sick and neutropenic after the first one we had to stop. Different people seem to do better. 

    My husband is a cancer doc himself and called several national experts...its a toss up. Right now some doctors see the benefit as marginal, others feel it is good yo do it if you can. we actually read the article you are referring to by the Chinese doctor. Asians have a much higher incidence of NPC so that is where most of the research comes from.

    The IMPORTANT thing is to get your chemoradiation done, preferably without interruption. The adjuvant is like extra credit. If you tolerate it easily than go for it but if you land in the hospital at risk for infection and sepsis like my husband it's best to forego it. Feel free to message me if you want to talk any more.

     

    Barbara

  • Hondo
    Hondo Member Posts: 6,636 Member
    #6
    Welcome to CSN H&N

    Hi Barry

    You will find that there are a lot of us NPC survivors here on CSN, I am sorry to hear you got this stuff but you are in the right place to be.

     God Bless

    Tim

  • caffinated1
    caffinated1 Member Posts: 32
    #7
    corleone said:

    Relatively easy, but need to consider that I had carboplatin (instead of cisplatin which was too toxic for ears, I lost 50% of hearing on the high frequency sound range), and 5FU. Carboplatin was easily tolerated, but 5FU is a pain in … wherever you want to say, because you have to carry a small pump for 5 days and nights with you (the infusion needs to be continuous, because the half-life of 5FU is very short), every month (3 rounds, over 3 months). Small pump, but I also had to carry the 1 liter bag with chemo. Others experienced this very differently, some had bad reaction to 5FU, other with cisplatin/carboplatin. Again, in my case, in terms of side effects was tolerable.

    That little 5FU pump was a

    That little 5FU pump was a treat to carry around.Cool

  • wmc
    wmc Member Posts: 1,804
    #8
    Welcome to the H&N Group

    Welcome, and sorry you need to be here. As I only had surgery I will let the others answer these questions. You have found a great site for sopport.

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    #9
    hi barry, i never had chemo

    hi barry, i never had chemo but i wanted to say welcome to our family and i'm sorry you need to be here.  we will help you and your wife get through this.  shock, that's an understatement.  that will soon pass though so get your war gear on and prepare to fight.  you can and will win this war.

    God bless you,

    dj

  • avisemi
    avisemi Member Posts: 172
    #10
    Barry,
    my husband finished

    Barry,

    my husband finished his treatment for NPC in February. He was also stage 4.  The road is hard but you can get through this!

    my husband had induction chemo (3 cycles of taxotere, cisplatin and 5fu) and then 35 rads with weekly carboplatin. They did induction because of how advanced his cancer was.  

  • lifeisDHA
    lifeisDHA Member Posts: 64
    #11
    my boyfriend had that

    additional chemo at the end. They wanted to do three more rounds and he could only do two. The first round was tough so the doc chanaged chemo drug in the second round to carboplatin+5fu. second was much easier.

     

     

  • BarryChen1010
    BarryChen1010 Member Posts: 27
    #12
    lifeisDHA said:

    my boyfriend had that

    additional chemo at the end. They wanted to do three more rounds and he could only do two. The first round was tough so the doc chanaged chemo drug in the second round to carboplatin+5fu. second was much easier.

     

     

    Thanks lifeisDNA and everyone

    Thanks lifeisDNA and everyone else for the replies. My doctor said the center (Seattle Cancer Care Alliance) has not performed adjuvant chemo for around 3 years. I am also afraid about the further toxic, so I didn't persist. I am now 2 weeks+ post treatments and still suffer the side effects. Hope the result will come good a few month later.

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