5-Fluorouracil Combined with Cisplatin Via Arterial Induction for Advanced T-Stage Nasopharyngeal Carcinoma: A 10-Year Outcome Study

Abstract

The aim of this study was to determine the efficacy, late adverse events, and 10-year survival outcome of 5-fluorouracil administered continuously for 120 h combined with cisplatin via a superficial temporal artery in patients with advanced T-stage nasopharyngeal carcinoma (NPC). Forty-five patients with histologically confirmed advanced T-stage NPC were eligible for inclusion in this clinical trial. The patients received induction chemotherapy consisting of cisplatin (20 mg/m2/d for 1–5 d) and 5-fluorouracil, administered continuously for 120 h at different dose gradients(200-500mg/m2/d) via a superficial temporal artery. Following two cycles of induction chemotherapy, radical radiotherapy was commenced. We assessed the efficacy, survival, toxicity, and quality of life of patients following treatment, especially in terms of oral mucositis and radiation-induced brain damage. The overall response (complete response + partial response) rates following induction chemotherapy in the primary mass and lymph nodes were 100% and 100%, respectively. The maximum tolerated dose(MTD) of 5-Fluorouracil was 450mg/m2,we also determined the optimal dose was 400mg/m2 according to the response, toxicities and survival. All 45 (100%) patients achieved down-staging of T-category after induction chemotherapy. No late neurological toxicities, such as brain stem injury, temporal lobe necrosis, and spinal cord injury, were observed. The 5-year and 10-year overall survival (OS) rates were 79% and 64.7%, with a median OS of 128 months. 5-Fluorouracil continuous infusion combined with cisplatin via a superficial temporal artery showed promising survival and low toxicities in patients with advanced T-stage NPC.