Effects of Induction Chemotherapy of Docetaxel, Cisplatin, and5-Fluorouracil Combining Intensity-Modulated Radiotherapy andConcurrent Chemotherapy in Locoregionally Advanced NasopharyngealCarcinoma

Purpose: Nasopharyngeal carcinoma (NPC) has the worldwide highest incidence in Southern China. Here, we investigate the efficacy and safety of induction chemotherapy of docetaxel, cisplatin, and 5-fluorouracil (TPF) plus concurrent cisplatin based intensity-modulated radiotherapy (IMRT) in locoregionally advanced NPC. Materials and Methods: From October 2009 to August 2012, 76 NPC patients treated by TFP induction chemotherapy plus concurrent cisplatin-IMRT were retrospectively recruited. The survival rate, accurate and late toxicities were further analyzed with 3 year follow-up. Results: The median follow-up time was 42 months (range, 8 to 60 months). The 3- year disease free survival (DFS), overall survival (OS), Local relapse free survival (LRFS), Distant metastasis free survival (DMFS) was 86.6%, 94.5%, 94.7%, and 89.2%, respectively. The major acute toxicities were myelosuppression, gastrointestinal disorders, and mucositis. The major late toxicities were skin reaction, xerostomia and hearing loss. Multivariate analyses indicated that lymph node metastasis status (N stage) was independent prognostic factor for DFS (P = 0.044, hazard ratio 4.832) and DMFS (P = 0.036, hazard ratio 7.309). Conclusions: TPF induction chemotherapy plus concurrent cisplatin-IMRT achieved satisfying 3-year survival rates with acceptable toxicities, suggesting that this combined therapeutic regimen might be effective for locoregionally advanced NPC.