Randomized clinical trial of radiotherapy combined with chemotherapy for advanced nasopharygeal carcinoma

OBJECTIVE:To evaluate the effect of chemotherapy combined with radiotherapy for treatment of the patients with advanced nasopharyngeal carcinoma.METHODS:Between May 1993 and March 1996,78 patients with stage Ⅲ/Ⅳ asopharyngeal carcinoma were randomized into two groups.Radiotherapy group(RT)(39 cases) was only treated by linear accelerator with DT 60-68 Gy in nesopharynx and DT 50-70 Gy in the neck. Radiotherapy combined with chemotherapy group ( RT/CT)(39cases) [cisplatin 30-40 mg/d iv.On days 1-3 and 5-fluorouracil 1 000 mg/d iv on days 1-5] received induction chemotherapy before/after and in radiotherapy(which started 1 week after the first cycle of chemotherapy).The methods and time/dose schedule of radiotherapy were similar in the two groups.RESULTS:The 5-year survival rates were 61.5%(24/39) in the RT/CT and 35.9%(14/39) in the RT respectively.The primary lesion control rates were 69.2%(27/39)(RT/CT) and 41.0%( 16/39) (RT),respectively.The cervical lymph node control rates were 64.1%(25/39)(RT/CT) and 38.5%(15/39)(RT) respectively.The side effect was myelosuipprossion,acute oral mucosa injury and gastrointestinal reaction in comprehensive group which were tolerable by the patients.CONCLUSIONS:Radiotherapy combined with induction chemotherapy can increase survival rates and decrease distant metabasis rates for advanced nasopharyngeal carcinoma.