Induction chemotherapy followed by radiotherapy and radiotherapy alone in patients with advanced nasopharyngeal carcinoma

Purpose:To evaluate the treatment results of induction chemotherapy followed by radiotherapy in patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma.Methods:Fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma were treated by induction chemotherapy followed by definitive radiation therapy (CT/RT group). This group was matched with a group of fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma treated with radiotherapy alone (RT group). Results: The 5 year loco regional control was 61.2% for the CT/RT Group and 68.7% for the RT Group; The 5 yera distant metastasis was 15.2% for the CT/RT group and 27.1% for the RT Group; The 5 year distant metastasis for the patients with stage N 2 and N 3 disease was 27.4% for the CT/RT Group and 43.8% for the RT Group respectively; The overall 5 year survival (OS) was 57.8% for the CT/RT group and 51.6% for the RT group( P =0 61); The 5 year OS of N 2 and N 3 patients was 60.6% for the CT/RT group and 26.3% for the RT group( P =0 033);The 5 year OS of T 3 and T 4 patients was 36.8% for the CT/RT group and 41.2% for the RT group ( P =0 80) respectively. There were no significant differences in the incidence of acute mucositis between the two groups during radiotherapy, the side effects in leukopenia, nausea, vomiting were higher in CT/RT group than in RT group. No Grade 3 or higher late complications were observed in both groups. Conclusions:Induction chemotherapy followed by definitive radiation therapy did not improve the 5 year survival and loco regional control for the stage Ⅲ and Ⅳ nasopharyngeal carcinoma, but reduced the distant metastasis for the stage N 2 and N 3 patients; The overall 5 year survival rate for the patients with N 2 and N 3 nasopharyngeal carcinoma was improved by induction chemotherapy followed by radiotherapy. [