Abstract:
Objective To observe the effect of combined radiotherapy and chemotherapy on advanced nasopharyngeal carcinoma (NPC) patients with two modalities.
Methods A total of 144 patients with local advanced NPC were randomly divided into two: synchronal and sequential therapy groups. In the former group, the patients were treated with external beam radiation (EBR) plus concurrent chemotherapy with thymidine phosphorylase. In the latter group, the patients received induction chemotherapy and radical radiotherapy plus three courses of adjuvant chemotherapy. Three-dimensional conformal radiotherapy and cisplatin-paclitaxel combination chemotherapy were performed. No difference in the means of radiotherapy and chemotherapy was found between the two groups.
Results All patients were followed up for at least 2 years. The local control rate and distant metastasis rate in the synchronal therapy group were 81.2% and 9.7%, respectively, whereas those in the sequential therapy group were 76.3% and 19.4%, respectively. For 2 year survivors, the tumor-free survival rates in the synchronal and sequential therapy groups were 76.4% and 66.7%, respectively.
Conclusion The preliminary results of EBR plus concurrent chemotherapy for local advanced NPC showed that the multimodality treatment could improve the local control rate and reduce distant metastasis rates. Compared with sequential therapy, multimodal therapy mainly increased mucositis incidence and severity. Generally, patients could tolerate the active treatment without increased side effects.
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