Concurrent oxaliplatin with radiotherapy for locoregionally advanced nasopharyngeal carcinoma

A randomised trial shows that concurrent oxaliplatin with radiotherapy improves survival outcomes compared with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma.Patients with locoregionally advanced nasopharyngeal carcinoma (NPC) have a five-year survival of between 10% and 40% and new regimes of concurrent chemoradiotherapy are needed. Oxaliplatin has no renal and fewer gastrointestinal toxicities than cisplatin and milder myelosuppression than carboplatin. This prospective, randomised, phase III trial assessed the use of concurrent weekly oxaliplatin with radiotherapy in 115 patients with locoregionally advanced NPC. Fifty-six patients were randomised to radiotherapy (RT) alone and 59 to concurrent chemoradiotherapy (CCRT) with six doses of oxaliplatin from the first day of RT.Results showed that after a median follow-up of 24 months, two-year overall survival was 100% for the CCRT arm and 77% for the RT arm (p = 0.01), metastasis free survival was 92% and 80% (p=0.02) and relapse free survival was 96% and 83% (p = 0.02) respectively. Complete response rate was 83% in the CCRT arm and 66% in the RT arm (p=0.032).Only 20% of patients experienced grade 1 or 2 toxicity, and Grade 1 or 2 leucopoenia and nausea and vomiting was seen more in the CCRT arm.The authors concluded that CCRT with weekly oxaliplatin improved survival outcomes in patients with locoregionally advanced NPC and that it should be assesses in combination with other agents and compared to concurrent cisplatin and radiotherapy. Reference...