The treatment of advanced nasopharyngeal carcinoma with hyperfractionated radiotherapy and chemotherapy

BACKGROUND: The nasopharyngeal carcinoma is a different entity in the carcinoma of the head and neck region. The radiation therapy is the treatment of choice but the combination of chemotherapy and radiotherapy improves the therapeutic results. METHODS: We have treated 26 patients. 9 females and 17 males. with an average age of 54 years. The first symptom was an adenopathy in 11 patients (42.3%). The treatment was made with hyperfractionated radiotherapy (115 cGy/fraction. 2 twice/day) with a total dose of 70 Gy in tumoral volume and 70 Gy in lymphatic areas. At the same time. the patients were treated with chemotherapy. CDDP 20 mg/m(2) (days 1-5). 5-fluorouracil 500 mg/m(2) (day 1) and tegafur 800 mg/day (21 days), during 6 cycles. RESULTS: All tumors were poor differentiated squamous-cell carcinomas. 25 cases were stage IV and one was stage III. The survival rate (Kaplan-Meier) after one year was 73% and after 2 and 5 years. 69%. The most frequent acute complications were mucositis in 1 I cases (42.3%) and leucopenia in 15 cases (57.6%). The chronic complication was xerostomia in 15 cases (57.6%). CONCLUSIONS: Ln the treatment of advanced carcinoma of the nasopharynx is important the combination of radiotherapy and chemotherapy. The hyperfractionated radiotherapy increases the delivered total dose without increasing the complications when it is associated with chemotherapy.