Long-term Result of Neoadjuvant Chemotherapy Plus Radiotherapy in the Treatment of Patients with ≥N_2 Nasopharyngeal Carcinoma

Objective To compare with long-term result of neoadjuvant chemotherapy plus radiotherapy and radiotherapy alone in ≥N2 nasopharyngeal carcinoma.Methods 188 patients with histologically proven ≥N_2 nasopharyngeal carcinoma (NPC) were randomized into two groups: Group A (94 cases) was treated with neoadjuvant therapy, receiving radiotherapy of 65～74Gy/6.5～8w to the nasoparynx and 58~72 Gy/5.8～7.2w to the neck after 2~3 cycles chemotherapy with PF Protocol (5-Fu and cisplatin: DDP ). Group B (94 cases) received the same radioitherapy alone.Results The complete response rates of nasoparynx and neck in the group A and B were 93.5% and 87.2% ;94.6% and 90.3%,respectively with no sighificant difference (P0.05). The 5 - year survival rate of group A was higher than that of the group B (70.8% vs 56.6%) (P0.05). The distant metastasis rate was 20.8% in group A and 30% in B group(P0.01). The mean time of distant metastasis was 19 months in group A and 9 months in group B with significant difference(P0.01).Conclusion Neoadjuvant chemotherapy (Plus radiotherapy) can increase the survival rate and local disease control, and can delay distant metastasis in patients with N2 nasopharyngeal carcinoma.