Induction chemotherapy for the treatment of non-endemic locally advanced nasopharyngeal carcinoma

// Lina Zhao 1 , Man Xu 1 , Wen Jiang 2 , Haitao Pan 3 , Jian Zang 1 , Shanquan Luo 1 , Jianhua Wang 1 , Yongchun Zhou 1 , Mei Shi 1 1 Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA 3 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA Correspondence to: Mei Shi, email: mshi82@hotmail.com Keywords: nasopharyngeal carcinoma, induction chemotherapy, IMRT, non-endemic region, WHO II/III Received: July 05, 2016 Accepted: December 05, 2016 Published: December 27, 2016 ABSTRACT Background : The role of induction chemotherapy is less clear in non-endemic locally advanced nanopharyngeal carcinomas (NPC). Results : With a total of 233 eligible patients and a median follow-up of 36 months, 3-year overall survival (OS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), disease free survival (DFS) were 84.5%, 94.9%, 78.6% and 69.2%, respectively. The overall failure rate was 21.0% and distant metastasis occurred in 17.2% patients. Multivariate analyses showed that retropharyngeal and bilateral neck lymph node metastasis were significant prognostic factors for DFS and OS. Moreover, patients receiving both GP (gemcitabine+cisplatin) and TP (docetaxel+cisplatin) regimes had significantly higher DFS and OS compared with PF (cisplatin+5-FU) regime. GP regimes lead to significantly improved OS than TP/PF in some subgroup of patients. No severe toxicities were observed. Materials and Methods : We retrospectively analyzed stage III-IVb NPC patients treated between Jan 2006 and Dec 2014, with induction chemotherapy followed by concurrent chemoradiation (IC-CCRT). Statistical analyses were performed on survival and failure patterns. Conclusions: These results suggested IC-CCRT was safe and effective for NPCs from non-endemic region. The choice of induction regimen appeared to affect patient outcomes.