Preliminary experience on treating advanced nasopharyngeal carcinoma (NPC) affecting/abutting neurological structures with induction chemotherapy followed by concurrent chemo-radiation with accelerated fractionation

5525 Background: To study the possibility of improving treatment tolerance and outcome for NPC with extensive infiltration affecting/ abutting neurological structures by induction chemotherapy followed by concurrent chemo-radiation with accelerated fractionation. Methods: During April 2001 to Feb 2003, 33 NPC patients with such ominous infiltration were treated with this strategy. Ninty-four percent of patients had UICC (5th edition) Stage IVA-B and 6% had Stage III disease. Thirty-two patients (97%) had undifferentiated carcinoma and only 1 patient had well differentiated squamous cell carcinoma. The chemotherapy plan included 3 cycles of Cisplatin (80 mg/m2 ) and Gemcitabine (1250 mg/m2 D1,8) for induction phase, and 2 cycles of Cisplatin (100 mg/m2 D1) for the concurrent phase. All patients were irradiated to a total dose of 70 Gy using 3-D conformal techniques and accelerated fractionation at 2 Gy per fraction, 6 daily fractions per week, throughout the whole course. Results: All patients completed th...