To assess the effect of chemotherapy in the treatment of nasopharyngeal carcinoma,48previously untreated patients admitted from Jan.1972 to Dec.1990 were analyzed.
The 5-year survival rate for 23 patients treated mainly with radiothera p y was 43.5%(Kaplan-Meier methods). The cause of death was mainly local-regional relapse and/or distant metastasis. Since 1982, we have adopted chemotherapy consisting of pepleomycin (5 mg intramuscular injection on days 1-7) and cisplatinum (50 mg/m2 by 24-hour continuous intravenous injection on day 8). We treated 25 patients (minimum follow-up duration was 13 months) with this chemotherapy,2-3 cycles prior to radiotherapy and/or more than 3 cycles after radiotherapy, every 3 weeks. One patient died of pulmonary fibrosis related to pepleomycin. The 5-year survival rate was 53.1% and the relapse rate 42.9%. In a group of 20 patients treated with induction chemotherapy, the 5-year survival rate and the relapse rate were improved to 59.7% and 29.4%, respectively, although the response rate to the induction chemotherapy was 55% (CR 3 cases, PR 8 cases). A new regimen will be needed to achieve a high CR rate.
Two of 6 patients treated w ith radical neck dissection survived and the operation was considered to be of significant benefit in nasopharyngeal carcinoma.
