Induction chemotherapy with docetaxel, cisplatin and fluorouracil followed by concurrent chemoradiotherapy or chemoradiotherapy alone in locally advanced non-endemic nasopharyngeal carcinoma

Objectives: To evaluate the efficacy of induction chemotherapy with docetaxel, cisplatin and fluorouracil (TPF) followed by concurrent chemoradiotherapy (IC + CCRT) or CCRT alone in non-endemic locally advanced nasopharyngeal carcinoma (NPC) patients. Materials and methods: Data of 106 patients with NPC treated from January 1999 to June 2012 with IC + CCRT (n = 58) or CCRT alone (n = 48) were retrospectively reviewed. Results: Median follow-up was 6.4 years. Distribution of age, performance status, stage and concurrent chemotherapy regimen were imbalanced between the two groups. The 5-year overall survival (OS) and progression-free survival (PFS) were not significantly different between IC + CCRT and CCRT groups (OS: 78.3% vs. 82.7%, p = 0.77; PFS: 72.5% vs. 68.2%, p = 0.81, respectively). There were less total cumulative incidence of grade 3-4 late radiation morbidity in the IC + CCRT group (44.8% vs. 70.8%, p = 0.01). Five-year OS for patients with post-IC complete response (CR), partial response (PR) and stable disease (SD) sub-groups were 100%, 79.4% and 60%, respectively. Conclusion: Compared with CCRT alone, IC (TPF regimen) + CCRT did not improve OS or PFS in patients with NPC, but less grade 3-4 late toxicities were observed. Responsiveness of IC may provide additional prognostic information