Safety and Efficacy of Induction Chemotherapy with Docetaxel Combined Oxaliplatin in Locally Advanced Nasopharyngeal Carcinoma

Objective：To evaluate the safety and efficacy of docetaxel and oxaliplatin induction chemotherapy in patients with locally advanced nasopharyngeal carcinoma (LANPC). Methods ：From May 2007 to June 2008, 35 previously untreated LANPC patients received induction chemotherapy with docetaxel ， 75 mg/m2, day 1 and oxaliplatin， 135 mg/m2, day 1, every 3 weeks.Nineteen patients were in Stage Ⅲ and 16 in Stage ⅣA.All patients but four received 2 cycles of induction chemotherapy.Total cycles were 66.All patients were evaluated for toxicity and responses. Results：Toxicities from induction chemotherapy were: 6.06% (4/66) grade 3 or 4 haematological toxicity of neutropenia, 62.12％（40/66）grade 1 or 2 and 1.5%（1/66）grade 3 fatigue，40.9％（27/66）grade 1 or 2 nausea/vomiting, 12.12％（8/66）grade 1 or 2 diarrhea，none had grade 3 or 4 gastrointestinal toxicity，13.63％（9/66）grade 1 or 2 arthralgia and myalgia，all patients had hair loss.In the end of induction phase，overall response rate（ORR） of nasopharyngeal primary lesion was 20.0%（7/35），ORR of metastatic lymph nodes was 79.31％（23/29，95%CI 65％~94％），with 13.79%（4/29） CR and 65.51％（19/29）PR respectively.No patient had PD in both nasopharyngeal primary lesion and metastatic lymph nodes. Conclusion：In LANPC induction chemotherapy with docetaxol plus oxaliplatin was well tolerated.High rate of response to induction therapy as well as to completed treatment was achieved.Long-term Therapeutic Effects of this sequence of treatment need further exploration.