Curative of Concurrent Chemotherapy and Intensity Modulated Radiotherapy Followed by Adjuvant Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma

ObjectiveTo evaluate the clinical effect and toxicities of concurrent chemoradiotherapy using intensity modulated radiotherapy (IMRT)plus adjuvant chemotherapy for locally advanced nasopharyngeal carcinoma. MethodsA total of 49 patients with locally advanced nasopharyngeal carcinoma (according to Fuzhou 92 staging system )were enrolled into this study, 30 patients had stage Ⅲ lesion while 19 patients had stage ⅣA. The regions of nasopharynx and upper neck were irradiated by IMRT technique.The lower neck and the supraclavicular fossa were irradiated with the conventional technique using an anterior field. The prescription doses were 73.9 Gy/33f for the gross tumor volume in the nasopharynx(GTVnx); 66Gy/33f for the positive neck lymph nodes (GTVnx)and the high risk regions (CTV1); and (50.4~59.4)Gy/(28~33)f for low risk regions (CTV2), respectively.Acute toxicities were evaluated according to EORTC/RTOG radiation morbidity scoring criteria .All patients received three cycles of adjuvant chemotherapy followed by concurrent chemoradiotherapy. ResultsWith a median follow-up of 28 months，the l-year local control rate was 100％, and the l-year overall survival and distant metastasis free survival were 97．96%and 95.92%，respectively．ConclusionConcurrent chemoradiotherapy with IMRT plus adjuvant chemotherapy for locally advanced nasopharyngeal carcinoma is a feasible method through to improve the local control rate and worthy of further clinical investigation. Grade 3 to 4 mucositis and grade 3 to 4 hematologictoxicity are considered to be induced by chemoradiotherapy and influence the quality of life．