Abstract
To assess the feasibility, efficacy and safety of 4 cycles of induction chemotherapy (ICT) followed by concurrent chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC) patients with N3 disease. ICT consisting of paclitaxel (135 mg/m2) and nedaplatin (80 mg/m2) given every 3 weeks for 4 cycles followed by cisplatin-based CRT was planned. 22 patients completed 4 cycles of TP regimen ICT and the CRT according to the protocol. After 4 cycles of ICT, the ORR of the primary site was 100% (CR 22.7%, PR 77.3%), and that of the cervical lymph nodes was 95.5% (CR 27.3%, PR 68.2%). After the completion of CRT, the ORR of the primary site was 100% (CR 81.8%, PR 18.2%), and that of the cervical lymph nodes also reached 100% (CR 86.4%, PR 3.6%). The main hematological adverse events were grade 1 to 2 (G1/G2) neutropenia/anemia without febrile neutropenia. The most frequent toxicities during CRT were G1/G2 neutropenia, asthenia, oropharyngeal mucositis and skin injury. The median follow-up time was 46.5 (14 to 75) months. The 3-year PFS, DMFS, LRFS and OS were 81.8%, 81.8%, 100%, and 90.9%, respectively. The results suggest that intensive ICT followed by CRT in NPC patients with N3 disease is effective and well tolerated.
Highlights
The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease
The results suggest that intensive induction chemotherapy (ICT) followed by CRT in Nasopharyngeal carcinoma (NPC) patients with N3 disease is effective and well tolerated
Results from the TAX 323 and TAX 324 trials had confirmed that more intense induction chemotherapy (ICT) could significantly improve the treatment outcomes for patients with locally advanced head and neck squamous cell carcinoma (SCC)[5,6]
Summary
The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease. Efficacy and safety of 4 cycles of induction chemotherapy (ICT) followed by concurrent chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC) patients with N3 disease. ICT consisting of paclitaxel (135 mg/m2) and nedaplatin (80 mg/m2) given every 3 weeks for 4 cycles followed by cisplatin-based CRT was planned. The 5-year locoregional control rate reaches ~90% after combined chemoradiation therapy even in patients with locally advanced disease. Despite of such superb long-term locoregional control rate, the risk of distant metastasis (DM). Remained at ~40% for locoregionally advanced NPC especially for those with T4 and N3 diseases, even after adding concurrent and neoadjuvant chemotherapy, to RT1. Adjuvant CT has not been commonly used due to lack of efficacy and high toxicity[3,4]
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