Induction chemotherapy with docetaxel, cisplatin and fluorouracil followed by concurrent chemoradiotherapy or chemoradiotherapy alone in locally advanced non-endemic nasopharyngeal carcinoma

Publication date: November 2016
Source:Oral Oncology, Volume 62
Author(s): Dan Ou, Pierre Blanchard, Clément El Khoury, Francesca De Felice, Caroline Even, Antonin Levy, France Nguyen, François Janot, Philippe Gorphe, Eric Deutsch, Stephane Temam, Yungan Tao
ObjectivesTo evaluate the efficacy of induction chemotherapy with docetaxel, cisplatin and fluorouracil (TPF) followed by concurrent chemoradiotherapy (IC+CCRT) or CCRT alone in non-endemic locally advanced nasopharyngeal carcinoma (NPC) patients.Materials and methodsData of 106 patients with NPC treated from January 1999 to June 2012 with IC+CCRT (n=58) or CCRT alone (n=48) were retrospectively reviewed.ResultsMedian follow-up was 6.4years. Distribution of age, performance status, stage and concurrent chemotherapy regimen were imbalanced between the two groups. The 5-year overall survival (OS) and progression-free survival (PFS) were not significantly different between IC+CCRT and CCRT groups (OS: 78.3% vs. 82.7%, p=0.77; PFS: 72.5% vs. 68.2%, p=0.81, respectively). There were less total cumulative incidence of grade 3–4 late radiation morbidity in the IC+CCRT group (44.8% vs. 70.8%, p=0.01). Five-year OS for patients with post-IC complete response (CR), partial response (PR) and stable disease (SD) sub-groups were 100%, 79.4% and 60%, respectively.ConclusionCompared with CCRT alone, IC (TPF regimen)+CCRT did not improve OS or PFS in patients with NPC, but less grade 3–4 late toxicities were observed. Responsiveness of IC may provide additional prognostic information.



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