Objective  To compare the efficacy and adverse reactions of induction chemotherapy combined with concurrent chemoradiotherapy(IC/CCRT) with those of concurrent chemoradiotherapy(CCRT) alone for patients with advanced nasopharyngeal carcinoma(NPC).

  Methods  From September 2003 to May 2006, 200 patients with advanced NPC treated in the Guangxi Baise People's Hospital were enrolled in this study.The patients were randomly divided into two groups: the IC/CCRT group, and the CCRT group.Patients in the two groups received the same concurrent chemoradiotherapy regimen consisting of caboplatin(AUC = 6) at days 7, 28, and 49 of the radiotherapy.Patients in the IC/CCRT group received two cycles of induction thermotherapy consisting of 5-FU(750 mg/m²) and caboplatin(AUC = 6) prior to the concurrent chemoradiotherapy.

  Results  TheⅢandⅣdegree adverse reactions of the IC/CCRT and CCRT groups were 25.4%and 17.9%, respectively(P < 0.001).The 3-year overall survival rates of the IC/CCRT and CCRT groups were 83.5%and 79.4%, respectively(P = 0.3).No significant difference in the 3-year disease-free survival rate, as well as in the locoregional control rate and the distant control rate of advanced NPC patients was observed between the two groups.

  Conclusion  Compared with CCRT alone, IC/CCRT does not significantly improve the overall and disease-free survival rates of advanced NPC patients.In addition, the acute adverse reactions were more severe in the IC/CCRT group.