ABSTRACT
To determine the efficacy and tolerability of concurrent chemoradiotherapy [CCRT] for the treatment of Malaysian patients with locoregionally advanced nasopharyngeal carcinoma. from May 2004 to May 2006, 30 patients with 1997 American Joint Committee on Cancer and Internation Union Against Cancer stages III to IV [M0] were treated with radiotherapy [66 grays] using shrinkage field technique and concurrent cisplatin 30 mg/m[2] weekly during the course of radiotherapy. After a median follow-up of 18 months 40% of the patients developed tumor relapse. The 2 years progression free survival [PFS] for stages III and IV was 70% and 30% respectively, and it was significantly better for stage III [p=0.005, Hazards ratio 0.60, 95% CI, 0.40 to 0.92], while PFS was not statistically different for sex [p=0.2, Hazards ratio 1.04, 95% CI, 0.64 to 1.71] or different age groups [p=0.23, Hazards ratio 1.03, 95% CI, 0.68 to 1.67]. The compliance with CCRT was high, all patients completed the proposed treatment and only 20% and 17% developed grade 3-4 mucositis and skin reaction respectively. We conclude that CCRT is feasible but the outcome is unsatisfactory, higher doses of radiotherapy and combination concurrent chemotherapy is warranted