The Role of Neoadjuvant Chemotherapy in Nasopharyngeal Cancer

Nasopharyngeal cancer is a common cancer in Asia as well in North Africa. Though concurrent chemoradiation therapy (CCRT) became standard treatment for advanced NPC patients, some high risk patients still have poor survival. Neoadjuvant chemotherapy has been an option in treatment of NPC. Up until now, there was no solid proof that NCT would positively impact the overall survival (OS) in advanced NPC. Different regimens were compared in the literatures, NCT plus radiation (RT) did not show improvement in OS as compared to RT alone, as well as NCT plus CCRT did not show benefit as compared to CCRT or CCRT plus adjuvant chemotherapy (ACT). Some trends of improving disease free survival (DFS) or distant recurrence free survival were observed, especially in certain group of patient with large local tumor or lymph nodes. More studies which focus on standard NCT regimen and narrowing down the target patients will be needed to further investigate the value of NCT in treatment of NPC.