Clinical study of neoadjuvant chemotherapy combined with radiotherapy for advanced nasopharyngeal carcinoma

Objective:To research the effects of neoadjuvant chemotherapy combined with radiotherapy for advanced nasopharyngeal carcinoma. Methods: From January 1998 to November 2002, 92 cases of nasopharyngeal carcinoma were devided into two groups. The patients of group A were treated by neoadjuvant chemotherapy before radiotherapy (n=48). The patients of group B were treated by radiotherapy alone (n=44). Both groups were given the same radiotherapy. Group A received 2 cycles of chemotherapy of PF regimen (5-Fu and DDP). They were treated with radiotherapy received DT (68~72)Gy/(7~7.5)W to the nasopharyngx and DT (50~76)Gy/(5~8)W to the neck. Results: After therapy the complete response rate for primary tumor were 60.4% in the neoadjuvant chemotherapy combined with radiotherapy (group A), and 38.6% in group B. The remission rates in the cervical lymph nodes were 66.7% VS 36.4%, with significant difference (P0.05).The occurring of leucocytte declining and membrance reaction in group A were more than those in group B. The one-year survival rates were 81.3% in group A and 81.8% in group B. The 3-year survival rate were 58.3% in group A and 61.3% in group B, without significant difference (P0.05). Conclusion: Neoadjuvant chemotherapy combined with radiotherapy can increase the local disease control in the patients with advanced nasopharyngeal carcinoma . But it failed to gain the survival benefit and reduce distant metastases.