2023 Volume 163 Pages 66-71
Chemotherapy (CT) and radiotherapy (RT) are the main curative treatments for nasopharyngeal cancer, because it is difficult to achieve complete resection. At our institution, the curative treatment for nasopharyngeal cancer has changed from neoadjuvant chemotherapy followed by radiotherapy (NAC + RT) to alternating chemoradiotherapy (ALCRT) or concurrent chemoradiotherapy followed by adjuvant chemotherapy (CCRT + AC). We investigated the outcomes in 57 patients with nasopharyngeal cancer who received NAC + RT (n = 14), ALCRT (n = 34), or CCRT + AC (n = 9) at our department between October 1999 and December 2018. The 5-year local control (LC), progression-free survival (PFS), and overall survival (OS) rates of the overall subject population (n = 57) were 79.4%, 58.1%, and 64.7%, respectively. The 5-year LC, PFS, and OS rates according to the clinical disease stage (St) were 94.4%, 84.4%, and 88.7% in patients with St I/II disease; 58.3%, 30.1%, and 41.8% in patients with St III disease; and 87.1%, 62.5%, and 64.2% in patients with St IV disease, respectively. The 5-year LC, PFS, and OS rates in the three treatment groups were as follows: 69.8%, 50%, and 56.3% in the NAC + RT group; 80.8%, 57.3%, and 65.7% in the ALCRT group; and 88.9%, 76.2%, and 77.8% in the CCRT + AC group. The CCRT + AC group exhibited favorable LC and survival rates, although the differences among the three groups were not significant. In the future, it is necessary to increase the frequency of CCRT + AC treatment and to additionally investigate the adverse events associated with these treatments.
