[Accelerated fractionated radiotherapy with concurrent chemotherapy in advanced nasopharyngeal carcinoma]

Clinical studies showed there is no satisfying treatment efficacy of the patients with advanced nasopharyngeal carcinoma (NPC) using conventional fractionated radiotherapy. It is important to treat the patients with advanced NPC using different fractionated radiotherapy and radiotherapy combined with chemotherapy. The current study was designed to evaluate the efficacy and radiation reactions of accelerated fractionated radiotherapy with concurrent chemotherapy for advanced NPC patients.

From June 1993 to June 1996, 416 patients pathologically confirmed NPC who firstly underwent radiotherapy were divided into three groups: accelerated fractionated radiotherapy group (AF group, n=138, 6 fractions per week, one time per day, 180-190 cGy per day to a total dose of 7,400-7,600 cGy). Accelerated fractionated radiotherapy with concurrent chemotherapy group (AFC group, n=139, 6 fractions per week, one time per day, 180-190 cGy per day to a total dose of 7,400-7,600 cGy, cisplatin and 5-FU one time per week) and conventional fractionated radiotherapy group (CF group, n=139, 5 fractions per week, one time per day, 200 cGy per day to a total dose of 7,000-7,600 cGy). The local recurrent rate, 5-year survival rate, and acute radiation reactions in the three groups were observed.

All patients were followed up for more than 5 years. The local recurrent rates in AF group (16.7%) and AFC group (13.6%) were lower than that in CF group (27.3%)(P< 0.05). The 5-year survival rates in AF group (53.6%) and AFC group (57.6%) were higher than that in CF group (43.8%)(P< 0.05). The acute radiation reactions in AF group (47.1%) and AFC group (51.1%) were higher than that in CF group (33.8%)(P< 0.05).

AF and AFC schedules are feasible in reducing local recurrent rate and enhancing 5-year survival rate for patients with advanced NPC. The acute radiation reactions of the AF and AFC groups are tolerable.