Short-term efficacy of radiotherapy alone versus radiotherapy followed by new adjuvant chemotherapy in treatment of T_4N_0M_0 nasopharyngeal carcinoma

Objective To compare local control efficacy and toxicity of radiotherapy(RT)followed by new adjuvant chemotherapy(NC)versus radiotherapy alone in treatment of patients with T_(4)N_(0)M_(0)stage Ⅳnasopharyngeal carcinoma(NPC).Methods From 2000 to 2004,62 stage T_(4)N_(0)M_(0) NPC patients were randomized into RT alone group and RT followed by NC group.The patients in the two groups were comparable in age,gender,stage and pathology.The NC group was treated with two courses of NC with DDP and 5-Fu before RT.Results The local control rates were 53.1% for RT group and 68.7%for NC group at the dose of 36 Gy(P0.05).At the total dose,the local control rates were 81.3% for RT group and 93.8% for NC group(P0.05).There was significant difference between the two groups in toxicity,such as nausea,vomiting and myelosuppression.Conclusion NC can significantly improve short-term efficacy and local control rates.but it has much toxicity.