Weekly paclitaxel with concurrent radiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma

Purpose: To evaluate the efficacy and toxicity of weekly-paclitaxel whit concurrent radiotherapy followed by adjuvant chemotherapy (AC) in patients with locally advanced nasopharyngeal carcinoma (NPC). Methods and materials. Between 2004 and 2007. 54 patients with locally advanced NPC were included in this protocol. Patient characteristics. median age 48: 69% male; 52% World Health Organization (WHO) III; 50%.: stage III. 50.% stage IV. The patients underwent a course of definitive conventional radiotherapy (70 Gy in 7 week; with 2 Gy/fraction), with concurrent weekly paclitaxel 35 mg/mz from the first to the sixth week of radiation. AC was started 4 weeks after the end of the radiotherapy (RT), paclitaxel 135 mg/m(2) on day 1 and cisplatin 30 mg/m(2) on days 1-3 were administered every 4 weeks for two cycles. Results: Median follow-up was 32 months. Eighty-five percentage of complete response and 15% partial response were achieved at the time of one month after AC. The 3-year actuarial rate of local re.-tonal control was 86%, distant metastases-free survival, progression-free survival and overall survival at 3 years were 81%, 691 and 76%, respectively Forty-nine (91%) patients completed SIX courses or concurrent chemotherapy with weekly paclitaxel, and 4 (7%) patients delayed at the second cycle of AC. No pattern developed severe acute toxicities Conclusions Weekly paclitaxel with concurrent RT followed by AC is a potentially effective and toxicity tolerable method for locally advanced NPC. Further studies are needed to identify the optimal dose of weekly paclitaxel in this strategy (C) 2009 Elsevter Iceland Ltd. All rights reserved Radiotherapy and Oncology 93 (2009) 488-491