Chemotherapy for Primary Treatment of Locoregionally Advanced Nasopharyngeal Carcinoma: Update on Meta-analyses and Phase III Trials

KS Tse, HY Wong, EYL Au, KM Ma

Hong Kong J Radiol 2005;8:93-101

Nasopharyngeal carcinoma is a prevalent cancer in Southeast Asia. Radiotherapy is the standard treatment for this highly radiosensitive and chemosensitive tumour, but the outcome of locally advanced nasopharyngeal carcinoma treated by radiotherapy alone is suboptimal owing to both local and distant failure. As a result, the role of chemotherapy has been studied extensively. In the light of research results newly released in 2004, this article aims to summarise the current debates on the primary treatment of nasopharyngeal carcinoma. Concurrent chemoradiotherapy with or without adjuvant chemotherapy has demonstrated survival benefits, but not adjuvant chemotherapy alone or neoadjuvant combined with adjuvant chemotherapy. Target groups of patients need to be identified to reap the maximum benefits of neoadjuvant chemotherapy. Further research is necessary to settle controversies on the choice, dosage, and schedule of chemotherapeutic agents, and to delineate the role of newer treatment modalities, such as molecular-level therapy.