Nasopharyngeal carcinoma: results of treatment by radiotherapy vs chemotherapy plus radiotherapy.

ABSTRACT

To determine the efficacy of neoadjuvant chemotherapy over radiotherapy alone in locally advanced nasopharyngeal carcinoma, a prospective non-randomized study was performed from 1 January 1982 to 31 December 1985 at Ramathibodi Hospital, Thailand. There were 69 new cases who completed treatment and were followed up at least once. Thirty-three cases were treated by radical radiotherapy (RT) alone and 36 cases by chemotherapy (CT) + RT. CT were by the combination of cis-diamminedichloroplatinum II and 5 fluorouracil. Of 32 cases, 2 courses of CT were given before RT and 1 after. The other 4 received 3 courses prior to RT. For both groups, RT technique and dosage were similar. Follow-up time of both groups ranged from 6-104 months (mean 50.3, median 50) and 8-100 months (mean 52.2, median 54.5), and total failures were 18/33 and 13/36, respectively, with no statistical difference (p greater than 0.05). Estimated actual survival and disease free survival from Kaplan-Meier curves at 3 years were about 75 per cent vs 75 per cent and 65 per cent vs 65 per cent, respectively, with no statistical differences (Log-Rank test). Therefore, we concluded that induction chemotherapy had some benefit but no statistical significance over RT alone. However, the role of maintenance chemotherapy is now being studied.