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This phase II clinical trial aimed to investigate the efficacy and safety of induction chemotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF regimen) followed by concurrent chemoradiation in patients with locally advanced nasopharyngeal carcinoma.MethodsEligible patients were aged 15–70years and had to have newly diagnosed locally advanced NPC (T3–T4 and/or N2–N3, M0), Karnofsky Performance Status (KPS) ⩾70, and normal or adequate kidney, liver, cardiovascular, and bone marrow functions. All patients were assigned to receive 3 cycles of induction chemotherapy in an outpatient setting every 3weeks with TPF regimen (docetaxel 75mg/m2 for day 1, cisplatin 75mg/m2 for day 1, 5-FU 750mg/m2/day with 8-h infusion on days 1–3) followed by 7weeks of concurrent chemoradiation (70Gy) with weekly cisplatin 30mg/m2.ResultsOverall, 74 courses of induction chemotherapy were administered. After induction chemotherapy, overall response rate was 84%. However, only one patient achieved a pathologic complete response. At the end of concurrent chemoradiation, 24 patients (96%) achieved clinical and pathologic complete response at both nasopharynx and regional nodes and one (4%) had persistent disease. Treatment-related toxicities were common but manageable. Grade 1–2 anemia was the most hematologic toxicity being detected in 51 cycles (68.9%) of induction chemotherapy. Four patients developed uncomplicated, culture-negative febrile neutropenia. There was no treatment-related death.ConclusionInduction chemotherapy with TPF regimen followed by concurrent chemoradiation is highly effective with manageable toxicity in patients with locally advanced nasopharyngeal carcinoma

egyptian journal of ear nose throat and allied sciences

The efficacy and safety of induction chemotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF) in treating patients with locally advanced nasopharyngeal carcinoma