Induction chemotherapy with carboplatin and taxol followed by radiotherapy and concurrent weekly carboplatin plus taxol in locally advanced nasopharyngeal carcinoma

Purpose Aim of this study was the clinical evaluation of carboplatin-taxol combination in a neoadjuvant and concomitant setting with conventional radiotherapy in loco-regionally advanced nasopharyngeal carcinoma (A-NPC). Methods Thirty patients were treated with three cycles of carboplatin (AUC6) plus taxol (175 mg/m(2)) on day 1 every 3 weeks, followed by weekly carboplatin (AUC1) plus Taxol (60 mg/m2) and concomitant radiotherapy (70 Gy). Results We observed the objective complete response rates of 33% (after chemotherapy) and 87% (after chemo-radiotherapy). Treatment tolerability and toxicity were controllable. Three- and five-year progression-free survival were 80 and 75%, respectively, and 3- and 5-year overall survival were 85 and 80% (follow-up 49.5 months). Five-year loco-regional control was 90.3%, and five-year distant metastases-free survival was 85%. Conclusions Neoadjuvant chemotherapy with such protocol represents a feasible, efficient treatment for patients with A-NPC, ensuring excellent loco-regional disease control and overall survival with low incidence of distant metastases.