Objective: To evaluate the effect of chemothrapy combined with radiotherapy in advanced nasopharyngeal carcinoma (NPC).
Methods: From Dec. 1989 to Dec. 1990, 76 patients with locally advanced NPC (stage III or IV) were treated with 3 cycles of cisplatin [PDD, 20 mg.(m2)-1.day-1, i.v. on days 1-5] and 5-Fluorouracil (5-Fu, 700 mg.(m2)-1.day-1 by continuous i.v. infusion on days 1-5 followed shortly thereafter by radiotherapy. Eighty-six patients treated with radiotherapy alone in 1989 were taken as control. The methods and time/dose schedule of radiotherapy were similar in the two groups.
Results: The response rate to chemotherapy was 89.3% [complete response (CR) 18.4%]. The overall 5-year survival was 48.7% in the combined treatment group and 33.6% in the control group (P > 0.05). The 5-year survival in the combined treatment group was 44.1% and 39.5%, in patients with T2N3 and T2-4N3 and 21.6% and 20.4% in the control group, respectively (P < 0.05).
Conclusion: This prospective study demonstrates that PDD/5-Fu chemotherapy followed by radiotherapy can improve 5-year survival in patients with T2-4N3 nasopharyngeal carcinoma.