Later course accelerated hyperfractionated radiotherapy combine chemotherapy for stage III and IV a nasopharyngeal carcinoma

Objective To evaluated the treatment results of late course accelerated fractionation radiotherapy for Stage Ⅲ and Ⅳa nasopharyngeal carcinoma. Methods 100 patients with stage Ⅲ and Ⅳa nasopharyngeal carcinoma were randomized into two groups. The late course accelerated hyperfractionated radiotherapy combine chemotherapy group(LCAF+CT group) received the induction chemotherapy for two cycles, followed by conventional fractionation radiotherapy to a dose 40 Gy, than changed into accelerated hyperfractionated radiotherapy to a total dose of 70 Gy, and use two cycles adjuvant chemotherapy, The conventional fractionation radiotherapy combine chemotherapy group(CF+CT group) received the chemotherapy that it similar to the LCAF+CT group, and use the conventional fractionation radiotherapy to a total dose of 70 Gy. Results The 3- and 5-year overall survival rate were 70.0% and 62.0% respectively in LCAF+CT group and 58.0 % and 46.0 % respectively in CF+CT group, had the significant difference (P 0.05). The 3- and 5-year disease free survival rate were 66.0% and 58.0% respectively in LCAF+CT group and 52.0 % and 42.0 % respectively in CF+CT group (P 0.05). The 3- and 5-year local-regional free rate were 76.0 % and 74.0 % respectively in LCAF+CT group and 62.0 % and 56.0 % respectively in CF+CT group (P 0.05). The 5-year distant metastasis rate were 18 % for the LCAF+CT group and 22 % for the CF+CT group (P 0.05). There were the cranial nerves complications in two patients of LCAF+CT group. Conclusions The results from this study show that the 3- and 5-year overall survival rate, the 3- and 5-year disease free survival rate and the 3- and 5-year local-regional free survival rate in LCAF+CT group was significant better than in CF+CT group, but the radiation-induced damage to the cranial nerves was improved in LCAF+CT group.