Improved survival for patients with nasopharyngeal cancers

Nasopharyngeal cancers are rare in most countries except China. Tumours are not resectable and traditional treatment is radiation. There are few large randomised clinical trials because of the low numbers of patients.Stage III to IV cancers treated with radiation show an actuarial survival at three and five years of 75% and 56% respectively, when using optimum radiotherapy treatment. This US study was of 27 patients with loco-regionally advanced nasopharyngeal cancer.1 Treatment was induction chemotherapy using cisplatin, 5-fluorouracil, leucovorin, and interferon alpha followed by chemoradiotherapy with 5-fluorouracil and hydroxyurea. The median follow-up of surviving patients was 82 months. Overall survival at three and five years was 88% and 77% respectively, and the progression free survival 92% and 86% respectively. One third of patients required reduction of chemotherapy dose mainly in the induction phase for acute toxicity. No chronic toxicity was seen.Results showed a patient compliance of 89% in the induction phase and 96% for the concomitant chemoradiotherapy treatment.Results showed that complete response rate was 54.2% and partial response rate was 45.8% after induction chemotherapy and 100% after the concomitant chemoradiotherapy. The authors conclude "although our study of 27 patients is small, its superior results, with acceptable toxicity, suggest that a further increase in survival rate is possible with intensified approaches. Our results warrant further investigation in a randomized setting to further outline the optimum treatment of these patients."Reference...