[Multimodality treatment of nasopharyngeal carcinoma]

In the treatment of nasopharyngeal carcinoma (NPC), radiation has been the treatment of choice, because it is effective for locoregional disease. However, the results of radiotherapy for NPC have revealed that local relapse and/or distant metastases occur frequently, and consequently the five-year survival rate is as low as around 30%. Since 1982, we have adopted chemotherapy initially applied prior to radiotherapy (= pre-radiation chemotherapy) for the treatment of NPC in order to achieve better results. The chemotherapy mainly consists of a combination of cisplatin and peplomycin. Twenty-one previously untreated patients with NPC were evaluable. Three complete and fifteen partial remissions were achieved, with an 86% response rate to the chemotherapy. The treatment involving a combination of pre-radiation chemotherapy and radiotherapy resulted in local relapse in one patient and distant metastases in two patients with an 87.5% survival rate according to the Kaplan-Meier method. Immunotherapy is also indispensable in the treatment of NPC. Our present multimodality treatment for NPC consists of a combination of pre-radiation chemotherapy and radiotherapy followed by long-term administration of a biologics such as OK-432.