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188 A. W. M. LeeTable 14.2. Phase II studies on induction–concurrent chemoradiotherapy for NPCRISCHINet al.(2002)OH et al.(2003)CHANet al.(2004)AL-AMROet al.(2005)JOHNSONet al.(2005)LEEet al.(2005c)YAUet al.(2006a)HUIet al.(2009)Patient characteristicsNumber enrolled 35 27 31 110 44 49 37 34Stage Group (AJCC-6) II–IVB II–IVB III–IVB II–IVB II–IVB IVA–B IVA–B III–IVBStage IVA–B (%) 40 NR 39 74 NR 100 100 44RadiotherapyTotal dose (Gy) 60 70 66 66 70 70 70 66Fractionation CF Split a CF CF CF AF AF CFChemotherapy scheduleInduction phaseNo. of cycles 3 3 2 2 3 3 3 2Cisplatin dose (mg/m 2 ) 75q3week100q3week- 100q3week100q3week100q3week100q3week75q3weekOther drugs EPI, FU FU, L, I J, T EPI FU FU G DConcurrent phaseNo. of cycles 2 7 6–8 3 2 b 2–3 2–3 6–8Cisplatin dose (mg/m 2 ) 100q5week- 40q1week100q3week330q1week100q3week100q3week40q1weekOther drugs - H, FU - - FU - -Tumor control (%)Time point (year) 4 5 2 3 3 3 3 3Locoregional control 97 93 90 c 68 75 c 77 78 NRDistant control 94 92 81 c 74 89 c 75 76 NROverall survival 90 77 92 71 78 71 76 94AJCC 6th American Joint Committee on Cancer 6th Edition; FU 5-fluorouracil; EPI epirubicin; J carboplatin; T paclitaxel; Iinterferon-a; H hydroxyurea; G gemcitabine; D docetaxel; NR not reported; CF conventional fractionation; AF acceleratedfractionationaSplit fractionation (2 Gy/fraction daily × 5 fraction, q 2 week)bLast 2 weeks of RT coursecCrude incidencelow-up is still relatively short for a full assessment oflate toxicities.In a subsequent study (Lee et al. 2008) on another20 patients treated by intensity-modulated radiotherapy,we further showed that induction chemotherapyusing the cisplatin/FU regimen couldachieve significant down-staging of T-category(p = 0.016): 25% of T3–T4 tumors became T1–T2,and another 10% decreased from T4 to T3.Furthermore, this could achieve significant reductionof tumor volume (p < 0.001): 70% of patientshad more than 50% reduction in primary tumor