According to a recent article published in the Journal of Clinical Oncology, the addition of chemotherapy to radiation therapy appears to improve long-term survival in patients with advanced nasopharyngeal cancer.

Nasopharyngeal cancer (NPC) is a type of head and neck cancer and occurs in the uppermost region of the throat situated behind the nasal cavity. Due to its anatomical location and the fact that NPC responds well to radiation therapy, most patients with NPC are treated with radiation therapy alone. Early-stage NPC, or cancer that has not spread from its site of origin is considered highly curable with radiation therapy alone. However, once the cancer has spread, survival rates begin to diminish. Therefore, researchers have been evaluating various treatment regimens in order to improve survival in patients with advanced NPC.

Recently, researchers from China and Taiwan conducted a clinical trial to directly compare chemotherapy plus radiation to radiation therapy alone in the treatment of NPC. This trial involved nearly 300 patients with NPC that had spread from its site of origin, but not to distant sites in the body. Approximately half of the patients were treated with chemotherapy consisting of fluorouracil and cisplatin plus radiation therapy and the other half were treated with radiation therapy alone. Five years following treatment, cancer relapses occurred in only 26% of patients treated with chemotherapy plus radiation, compared to 46% of patients treated with radiation therapy alone. Overall survival at 5 years was 72% for patients treated with chemotherapy plus radiation, compared to 54% for patients treated with radiation therapy alone. Progression-free survival at 5 years was approximately 72% for patients treated with chemotherapy plus radiation, compared to 53% of patients treated with radiation therapy alone. Side effects, including low white blood cell levels and vomiting, were more prominent in the group of patients treated with chemotherapy plus radiation therapy.

These researchers concluded that the addition of chemotherapy to radiation therapy appears to significantly improve long-term survival in patients with NPC that has spread locally. Patients diagnosed with NPC may wish to speak with their physician about the risks and benefits of the addition of chemotherapy to radiation therapy or the participation in a clinical trial further evaluating novel therapeutic regimens. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov).

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Reference: Lin J-C, Jan J-S, H C-Y, et al. Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival.

Journal of Clinical Oncology. 2003;21:631-637.