Journal of Clinical Oncology, Vol 11, 1919-1928, Copyright © 1993 by American Society of Clinical Oncology
Effectiveness of combined induction chemotherapy and radiotherapy in advanced nasopharyngeal carcinoma
IW Dimery, LJ Peters, H Goepfert, WH Morrison, RM Byers, C Guillory, K McCarthy, RS Weber and WK Hong
Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston.
PURPOSE: This prospective trial was conducted with the goal of achieving an
improvement in both overall and progression-free survival in previously
untreated patients with stage IV nasopharyngeal carcinoma who received an
induction chemotherapy regimen of fluorouracil (5-FU) and cisplatin
followed by radiotherapy. PATIENTS AND METHODS: From January 1985 to
January 1990, 47 patients with T1-4N2-3M0 squamous cell carcinoma of the
nasopharynx were treated at The University of Texas M.D. Anderson Cancer
Center with two to three cycles of 5-FU (1,000 mg/m2 continuous infusion
per day x 5 days) plus cisplatin (100 mg/m2 continuous infusion on day 1
only) followed by radiotherapy using the conventional time/dose schedule.
RESULTS: The response rate to chemotherapy was 93.2% (20.5% complete
response [CR]; 72.7% partial response [PR]), and the overall CR rate after
radiotherapy was 86%. With a median follow-up period of 53 months, the 2-,
4-, and 6-year survival rates were 80%, 71.6%, and 67.4%; the overall
treatment failure rate was 27%. Treatment was well tolerated and without
significant acute or chronic toxic effects. CONCLUSION: The results of this
prospective study demonstrate that 5-FU plus cisplatin followed by
radiotherapy can induce a durable remission in a high proportion of
patients with poor-prognosis stage IV nasopharyngeal carcinoma.
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