Abstract
The value of adding induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) for the treatment of locoregionally advanced nasopharyngeal carcinoma (NPC) remains unclear. In our recent article entitled “Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial” published in the Lancet Oncology, we reported the results of a phase III, multicenter, randomized controlled trial comparing cisplatin, 5-fluorouracil, and docetaxel (TPF) IC plus CCRT versus CCRT alone in patients with T3-4N1/TxN2-3M0 NPC (ClinicalTrials.gov registration number NCT01245959). The IC-plus-CCRT group showed significantly higher 3-year failure-free survival, overall survival, and distant failure-free survival rates than the CCRT-alone group, with an acceptable toxicity profile. Our study suggests that adding TPF IC to CCRT could increase survival rates and reduce distant failure in patients with locoregionally advanced NPC. However, long-term follow-up is required to assess the eventual efficacy and toxicity of this strategy, and a more accurate method to determine prognosis is needed to enable better tailoring of treatment strategy for individual patients.
Highlights
In our recent article entitled “Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial” published in the Lancet Oncology, we reported the results of a phase III, multicenter, randomized controlled trial at 10 institutions in China, which compared cisplatin, 5-fluorouracil, and docetaxel (TPF) induction chemotherapy (IC) plus CCRT vs CCRT alone in the treatment of locoregionally advanced Nasopharyngeal carcinoma (NPC) (ClinicalTrials.gov registration number NCT01245959) [12]
In a randomized phase II study by Hui et al [6], IC with docetaxel and cisplatin followed by CCRT resulted in a 3-year overall survival (OS) benefit compared with CCRT alone in patients with stage III–IVB NPC; in another phase II trial, by Fountzilas et al [7], IC using cisplatin, epirubicin, and paclitaxel followed by CCRT did not significantly increase OS or progressionfree survival rate compared with CCRT alone
Main text In our recent article entitled “Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial” published in the Lancet Oncology, we reported the results of a phase III, multicenter, randomized controlled trial at 10 institutions in China, which compared cisplatin, 5-fluorouracil, and docetaxel (TPF) IC plus CCRT vs CCRT alone in the treatment of locoregionally advanced NPC (ClinicalTrials.gov registration number NCT01245959) [12]
Summary
Nasopharyngeal carcinoma (NPC) is a unique head and neck cancer with an extremely unbalanced endemic distribution [1, 2]. To further improve systemic control and survival of patients with locoregionally advanced NPC, adding induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) seems to be a promising treatment strategy. In a randomized phase II study by Hui et al [6], IC with docetaxel and cisplatin followed by CCRT resulted in a 3-year OS benefit compared with CCRT alone in patients with stage III–IVB NPC; in another phase II trial, by Fountzilas et al [7], IC using cisplatin, epirubicin, and paclitaxel followed by CCRT did not significantly increase OS or progressionfree survival rate compared with CCRT alone. CCRT with CCRT alone in patients with stage III-IVB NPC and observed no significant survival differences between the two groups. The efficacy of IC followed by CCRT in locoregionally advanced NPC still lacks solid evidence from large-scale randomized controlled trials
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