Abstract
Objectives: To improve the survival rate in patients with nasopharyngeal squamous cell carcinoma (NSCC). Material and Methods: A total of 56 patients with NSCC were enrolled in this study, in order to observe the long-term survival. The primary site was treated conservatively with neoadjuvant chemotherapy (NAC) and concurrent chemoradiation therapy (CCRT), using superselective intra-arterial infusion chemotherapy (SSIAC) with cisplatin, docetaxel, and 5-fluorouracil. Cervical lymph node metastasis was treated using neck dissection. Results: The 5- and 10-year overall survival rates were 67.9 and 60.5%, respectively. The 5- and 10-year survival rates improved particularly in patients with T3 cancer (96.5 and 96.5%, respectively), N1 cancer (100 and 100%, respectively), and poorly-differentiated cancer (88.2 and 79.2%, respectively). In contrast, the 5- and 10-year survival rates were worse in patients with T4 cancer (28.7 and 0%, respectively), N3 cancer (11.1 and 0%, respectively), and moderately-differentiated cancer (18.7 and 0%, respectively). There were significant differences in the overall survival rates between patients with stage III and IVA, stage III and IVB, and between IVA and IVB NSSC. Conclusion: We demonstrated that NAC and CCRT using SSIAC, with neck dissection to control cervical lymph node metastasis, were safe and effective in patients with NSCC. The introduction of maintenance therapy and intensity-modulated radiation therapy (IMRT), as well as molecular-targeted drugs and heavy-particle radiotherapy, should be considered.
