Concurrent Chemoradiotherapy for Nasopharyngeal Carcinoma

the Effectiveness and Toxicity

Abstract

Nasopharyngeal carcinoma (NPC) is difficult to diagnose in the early stage due to a lack of typical symptoms. In addition, the surgical treatment of NPC is very difficult to perform due to the anatomical characteristics. Most NPCs are histologically classified as undifferentiated or poorly differentiated carcinoma, and these histological cancers are sensitive to radiotherapy. NPCs are also sensitive to chemotherapy. Recently, some randomized trials investigating the efficacy of chemotherapy combined with radiotherapy in NPC have demonstrated that the combination of chemotherapy and radiotherapy significantly improved disease-free/progression-free survival rates compared to those with radiotherapy alone. In the present study, we investigated the efficacy of concurrent chemoradiotherapy (CCRT) for NPC. Thirteen NPC patients treated with CCRT in our hospital between 1999 and 2004 were analyzed retrospectively. The three-year overall and progression free survival rates were 90% and 80%, respectively. The efficacy of CCRT was favorable. However, various adverse events also occurred. In the early phase of CCRT, most patients were complicated with leucopenia and mucositis. In addition, all patients suffered from dry mouth, and most suffered from intermittent otorrhea and hearing impairment for a prolonged period. Two severe adverse events occurred: one patient showed extensive brain necrosis, and the other showed massive hemorrhage from a pseudaneurysm of the internal carotid artery. Although CCRT is effective for NPC, patients should be treated with caution regarding the toxicity of CCRT. Long-term follow-up is also necessary.