Efficacy of Intensity-Modulated Radiotherapy with concurrent carboplatin in nasopharyngeal carcinoma
Purpose: To evaluate the efficacy and toxicities of concurrent carboplatin with Intensity-Modulated Radiotherapy (IMRT) in the treatment of NPC.
Materials and Methods: Between October 2005 and November 2011, 73 stage II-IVB NPC patients received IMRT 70 Gy concurrently with three cycles of carboplatin (AUC5) every three weeks, followed by three cycles of adjuvant carboplatin (AUC5) and 5-FU (1,000 mg/m2/day for four days) every four weeks. All patients were evaluated for tumor response using RECIST criteria, survival analysis using Kaplan-Meier methods, and toxicities according to CTCAE version 4.0.
Results: At three months after chemoradiation, 82.2% and 17.8% achieved complete and partial response, respectively. With a median follow-up of 48.1 months (1.3-97.8 months), 8.2% and 17.8% had local recurrence and distant metastasis. Median survival was not reached. Three-year overall survival and progression-free survival were 83.6% and 65.3%. Regarding treatment compliance, 97.2%, 69.9% and 68.5% completed radiation treatment, concurrent carboplatin and adjuvant chemotherapy, respectively. Grade 3-4 acute toxicities were oral mucositis (16.4%), dysphagia (16.4%), xerostomia (15.1%) and hematotoxicity (6.8%).
Conclusion: Giving carboplatin concurrently with IMRT provided excellent tumor response, manageable toxicities and good compliance. This should be considered as an alternative treatment for NPC patients.