Chemotherapy with or without radiotherapy in patients with locoregionally recurrent nasopharyngeal carcinoma

Head Neck. 2002 Jun;24(6):549-54. doi: 10.1002/hed.10098.

Abstract

Background: Treatment of locoregionally recurrent nasopharyngeal carcinoma (NPC) is challenging because of prior radiotherapy, morbidities from disease recurrence, and limited therapeutic options available.

Methods: A retrospective study of patients with locoregionally recurrent NPC.

Result: Between March 1994 and December 1999, there were 42 patients; most were Chinese (98%) men (81%) with undifferentiated NPC (86%). A repeat course of radiotherapy was feasible in 20 patients and given concurrently with cisplatin followed by adjuvant cisplatin/5-fluorouracil (PF) (group 1). The remaining 22 (group 2) received palliative chemotherapy (PF) with a response rate of 50%. Significant morbidities resulted from cranial nerve palsies. The 2-year progression-free survival of patients in group 1 was expectedly better (58% vs 38%). Six (14%) developed systemic metastases at 12 months (median) from first recurrence.

Conclusion: Concurrent chemoradiotherapy for locoregional recurrent NPC seems promising. The morbidity experienced resulted from locoregional disease with few progressing to develop systemic involvement.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant
  • Cisplatin / therapeutic use*
  • Disease Progression
  • Female
  • Fluorouracil / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms / drug therapy*
  • Nasopharyngeal Neoplasms / mortality
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / radiotherapy*
  • Palliative Care
  • Radiotherapy Dosage
  • Retrospective Studies

Substances

  • Cisplatin
  • Fluorouracil