Neoadjuvant chemotherapy and radiotherapy versus radiotherapy alone in patients with advanced nasopharyngeal carcinoma

ABSTRACT

A randomized study was carried out between January 1987 and December 1993 at the Kuwait Cancer Control Centre, to evaluate the efficacy of neoadjuvant chemotherapy and radiotherapy over radiotherapy alone inpatients with locally advanced nasopharyngeal carcinoma. Forty three patients were randomized to recive either neoadjuvant chemotherapy and radiotherapy [Combination arm] or radiotherapy alone. All the patients had stage IV disease. The tolerance to combination arm was inferior to that of radiation arm. There was no difference in the locoregional control rate between the two arms. Response rate following chemotherapy was 88%, which increased to 94% following radiotherapy. The overall response rate in the radiotherapy arm alone was 95%. At the median one of year of the follow up the failure rate in the radiotherapy arm was 26% and in the combination arm 24%. Three patients in the combination arm and two patients in the radiotherapy arm developed distant metastses