Induction chemotherapy with cisplatin and gemcitabine followed by accelerated radiotherapy and concurrent cisplatin in patients with stage IV(A-B) nasopharyngeal carcinoma

Background. The purpose of this study was to evaluate the efficacy and toxicity of cisplatin plus gemcitabine as induction chemotherapy in advanced nasopharyngeal carci- noma (NPC). Methods. Thirty-seven patients with stage IV(A-B) NPC were treated with 3 cycles of cisplatin plus gemcitabine (cisplatin 80 mg/m 2 on day 1; gemcitabine 1250 mg/m 2 on days 1 and 8) 3-weekly as induction chemotherapy, followed by another 3 cycles of concurrent cisplatin (100 mg/m 2 on day 1) 3-weekly with accelerated radiotherapy (RT) at 70 Gy in 2-Gy fractions, 6 daily fractions per week. Results. The overall response rate to induction chemother- apy was > 90%, and side effects other than uncomplicated he- matologic toxicities were uncommon. All patients completed RT, with 92% receiving � 5 cycles of chemotherapy. At a median fol- low-up of 2.9 years, the 3-year overall survival (OS) and disease- free survival (DFS) rates were 76% and 63%, respectively. Conclusions. Cisplatin plus gemcitabine is a well-tolerated, effective, and convenient induction chemotherapy regimen and warrants further studies to confirm its benefit in advanced NPC. V C 2006 Wiley Periodicals, Inc. Head Neck 28: 880-887, 2006