[Chemotherapy in nasopharyngeal carcinoma]

Nasopharyngeal carcinoma (NC), especially the undifferenciated type, is a rare malignant disease. Prevalence is high in Southeast Asia and North Africa.

To determine the role of chemotherapy in the treatment of cancers of the nasopharynx.

[corrected] A search of the MEDLINE databases from 1970 to 2005, for articles testing chemotherapy in nasopharyngeal carcinoma. The key words: Nasopharyngeal carcinoma, chemotherapy, concurrent chemo-radiation, were used to access to principal trials.

Nine phase III randomised trials, testing the combination of chemotherapy and radiotherapy in nasopharyngeal carcinoma were found. There us increasing evidence attesting to the beneficial effect of adding of chemotherapy to radiotherapy in the treatment of locally advanced disease (stage III and IV), especially concurrent chemo-radiation, considering the benefit in terms of overall survival. Associations containing cisplatin proved to be most effective. New molecules (capecitabine, taxanes, gemcitabine...) are currently in the course of testing, in phase II studies, for recurrent and metastatic NC, for which there is not still standard treatment.

Medline review reveals that concurrent chemo-radiation, containing cisplatin, is standard treatment for locally advanced nasopharyngeal carcinoma. Metastatic disease is treated by palliative chemotherapy.