Clinical study of concurrent chemotherapy with PF protocol plus radiotherapy and adjuvant chemotherapy to nasopharyngeal carcinoma

OBJECTIVE:To evaluate the effects and toxicities of concurrent chemotherapy(CT) plus radiotherapy(RT) and adjuvant chemotherapy in the treatment of patients with nasopharyngeal carcinoma of stage Ⅲ-ⅣA. METHODS:A total of 96 cases of stage Ⅲ-ⅣA of nasopharyngeal carcinoma were randomly allocated into 2 groups. Group A: 48 patients were treated by 2 cycles of concurrent CT plus RT, plus 1-2 cycles adjuvant CT. Concurrent CT was given by PF protocal, DDP 30 mg/m2, Ⅳ drop, d1-d3 or CBP 60 mg/m2, iv drop, d1-d5; 5-FU 600 mg/m2, iv drop, d1-d5, at the 1st week of RT, 2 cycles CT during the RT, plus 1-2 cycles adjuvant CT with the same protocol after RT. All 96 patients were treated by RT with 6 MV X-ray by the use of lateral facio-cervical fields to 36 Gy and 34 Gy by the use of small lateral facio-cervical fields in order to protect the cervical spinal cord, +6-12 MeV-β-ray, 2 Gy/F, 70-78 Gy to the primary carcinoma of nasopharynx and the positive cervicallymph nodes, 50 Gy to the region of negative lower cervical and super-clavicular lymph nodes by use of tangential field. Group B: 48 patients were treated by RT alone with the same method in Group A. RESULTS: In Group A and Group B, the 3-year disease free survival rates and the 3-year overall survival rates were 79.2% vs 52.1% (χ2=7.804, P=0.005);83.3% vs 64.6% (χ2=4.381, P=0.036) respectively. There existed significant differences between the two groups. CONCLUSION: Concurrent CT plus RT and adjuvant CT is a safe and more effective therapy for patients with nasopharyngeal carcinoma of stage Ⅲ-ⅣA compared to RT alone, and the side effects were acceptable.