1035P - The Randomized Study Comparing the Efficacy and Safety of Radio-Chemotherapy Plus Adjuvant Chemotherapy (CCRT) Vs. Neo-Adjuvant Chemotherapy Plus Radio-Chemotherapy (NAC-RT) for Locally Advanced Nasopharyngeal Cancer

Abstract

ABSTRACT Purpose Nasopharyngeal carcinoma is radio-chemosensitive. Local control and survival of patients with advanced disease treated by radiotherapy alone remains unsatisfactory. Chemotherapy has been combined with radiotherapy to increase local-regional control, decrease distant metastasis, and improve survival of the patients. We have developed a randomized trial comparing the efficacy and toxicities of CCRT versus NAC-RT for locally advanced nasopharyngeal cancer. Patients and methods A total of 175 patients were included in the study. The 87 patients received concurrent radio-chemotherapy daily 70 Gy/7 weeks with cisplatin 100 mg/m2 q 3 weeks then followed by adjuvant chemotherapy for 3 cycles (q 3 weeks), consisting of cisplatin 80 mg/m2 on day 1 and 5-FU 1,000 mg/m2 on day 1-4. The 88 patients received neoadjuvant chemotherapy for 3 cycles (q 3 weeks) consisting of docetaxel 75 mg/m2 on day 1, cisplatin 75 mg/m2 on day 1, and 5-FU 750 mg/m2 on days 1- 4 followed by concurrent radiotherapy daily 70 Gy/7 weeks with carboplatin AUC 1.5 weekly for 6 weeks. Results The number of patients who completed treatment for the CCRT group was 34 (39.1%) and for the NAC-RT group was 54 (61.4%). The most common reasons for study discontinuation were adverse events and patient's willingness. The grade 3 and 4 treatment-related adverse events were two times higher in the CCRT group(p Conclusion Induction chemotherapy with docetaxel / cisplatin and 5-fluoro-uracil followed by concurrent radio-chemotherapy was tolerable and provided well control of disease. These interim early results revealed no difference in PFS but less side effects and increase number of the patients with no evidence of disease in the NAC-RT arm. Disclosure All authors have declared no conflicts of interest.