Chemotherapy as part of the initial treatment for nasopharyngeal cancer

Although external beam radiation therapy is the standard treatment for nasopharyngeal carcinoma, there has been increasing interest in the use of adjunctive chemotherapy. Unfortunately, studies evaluating its role in this disease are retrospective, and have included significant numbers of patients who would have done well with external beam radiation therapy alone. The authors have reviewed the available literature on adjunctive chemotherapy for cancer of the nasopharynx and have attempted to define which patients should be considered for study. They have concluded that no patients should be treated with systemic therapy outside of an investigational protocol, and that these protocols should only include those with T3, T4, N2 or N3 disease. Programs using optimal cisplatin-containing regimens and those using concomitant chemotherapy and external beam radiation therapy warrant further attention.