To study the response of locally advanced nasopharyngeal cancer to concurrent chemo-radiotherapy

Objective: To ascertain the response of concurrent chemoradiotherapy in patients with locally advanced (Stage III-IVB) nasopharyngeal carcinoma. Design: It was a retrospective case series. Setting: Institute of Nuclear Medicine and Oncology (INMOL), Lahore Subjects: Thirty-three eligible patients out of 89 with stage III-IVB were included. Interventions: The TNM staging used for this study was that described in the 7th edition of AJCC Cancer Staging Manual. Patients received two cycles of Cisplatin 75 mg/m(2) and 5-FU 1000 mg/m(2), D1 and D1-D5, thrice weekly as neo-adjuvant chemotherapy followed by definitive CCRT of 66-70 Gy in 33-35 fractions. Main outcome measures: CT/MRI images were done after six weeks of completion of chemo-radiation and were compared with base line imaging for response evaluation. Three-year overall survival (OS), three-year local recurrence free survival (LRFS) and three-year distant metastatic free survival (DMFS) were primary endpoints of study. Results: Median age of the patient population was 49 years. Male to female ratio was 1.75:1.00. WHO Type 1 keratinizing squamous cell carcinoma was the most common histology (48.5%), majority was presented in stage IVA (48.5%, n=16), T4 was common tumor size (66.7%, n=22) and N2 was the most common stage of nodal involvement (54.5%, n=18). Complete and partial responses were observed in 54.5% (n=18) and 27.3% (n=9) of the cases respectively. Three-year OS was 51.5% (n=17), LRFS was 81.8% and DMFS was 60.6%. Conclusion: Chemo-radiotherapy is effective in locally advanced nasopharyngeal carcinoma in terms of complete response, partial response, OS, LRFS and DMFS.