Application of induction PF chemotherapy plus concurrent chemo-radiotherapy in patients with Iocoregional advanced nasopharyngeal carcinoma

Abstract

Objective To investigate the efficacy and safety of induction chemotherapy(DDP + 5-FU)followed by concurrent chemo-radiotherapy(CCRT)in patients with locoregional advanced nasopharyngeal carcinoma (NPC).Methods 42 patients with locoregional NPC were enrolled in the study.Before CCRT,patients were assigned to receive two cycles of chemotherapy(DDP 20mg/m2 d1～5 ;5-FU 750mg/m2 d1～5)every three weeks.Then the same chemotherapy was given from the first day of standard radiotherapy.Results All patients completed planned treatment and were eligible for toxicity and response analysis.After induction chemotherapy,9 patients achieved complete response in nasopharynx and 12 patients achieved CR in regional nodes;Three months after radiotherapy,41 patients achieved CR in nasopharynx and 34 patients achieved CR in regional nodes.Induction PF was well tolerated and the most common acute high-graded toxicity of CCRT was grade Ⅲ mucositis(35.7％)and grade Ⅲ vomiting (16.7％).At median follow-up of 15 months,the overall survival rate was 100％,two-year cumulative local recurrence rate was 4.8％ and distant metastasis rate was 2.4％.Conclusion Induction PF chemotherapy plus concurrent chemo-radiotherapy was tolerable and satisfactory for patients with locoregional NPC. Key words: Nasopharyngeal carcinoma; Induction chemotherapy; Concurrent chemo-radiotherapy; Cisplatin; 5-Fluorouracil