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Background:In the era of intensity?modulated radiotherapy(IMRT),the role of neoadjuvant chemotherapy(NACT)in treating ascending?type nasopharyngeal carcinoma(NPC)is under?evaluated.This study was to compare the efficacy of NACT followed by IMRT(NACT+RT)with the efficacy of concurrent chemoradiotherapy(CCRT)on ascending?type NPC.Methods:Clinical data of 214 patients with ascending?type NPC treated with NACT+RT or CCRT between Decem?ber 2009 and July 2011 were analyzed.Of the 214 patients,98 were treated with NACT followed by IMRT,and 116 were treated with CCRT.The survival rates were assessed using Kaplan–Meier analysis,and the survival curves were compared using a log?rank test.Results:The 4?year overall survival,locoregional failure?free survival,distant failure?free survival,and failure?free sur?vival rates were not significantly different between the two groups(all P>0.05).However,patients in the CCRT group exhibited more severe acute adverse events than did patients in the NACT+RT group during radiotherapy,includ?ing leukopenia(30.2%vs.15.3%,P=0.016),neutropenia(25.9%vs.11.2%,P=0.011),and mucositis(57.8%vs.40.8%,P=0.028).After radiotherapy,patients in the CCRT group exhibited significantly higher rates of xerostomia(21.6%vs.Conclusions:The treatment outcomes of the NACT+RT and CCRT groups were similar;however,CCRT led to higher rates of acute and late toxicities.NACT+RT may therefore be a better treatment strategy for ascending?type NPC.
Background: In the era of intensity? Modulated radiotherapy (IMRT), the role of neoadjuvant chemotherapy (NACT) in treating ascending? Type nasopharyngeal carcinoma (NPC) is under evaluated.This study was to compare the efficacy of NACT followed by IMRT ( NACT + RT) with the efficacy of concurrent chemoradiotherapy (CCRT) on ascending? Type NPC. Methods: Clinical data of 214 patients with ascending? Type NPC treated with NACT + RT or CCRT between Decem ber 2009 and July 2011. Of the 214 patients, 98 were treated with NACT followed by IMRT, and 116 were treated with CCRT. The survival rates were assessed using Kaplan-Meier analysis, and the survival curves were compared using a log? rank test. Results: The 4? year The overall survival, locoregional failure? free survival, distant failure? free survival, and failure? free sur? vival rates were not significantly different between the two groups (all P> 0.05) .Wever, patients in the CCRT group exhibited more severe acute adverse events than did patients in the NACT + R T group during radiotherapy, includ ing leukopenia (30.2% vs.15.3%, P = 0.016), neutropenia (25.9% vs.11.2%, P = 0.011), and mucositis (57.8% vs.40.8%, P = 0.028) . After radiotherapy, patients in the CCRT group showed significantly higher rates of xerostomia (21.6% vs. Conclusions: The treatment outcomes of the NACT + RT and CCRT groups were similar; however, CCRT led to higher rates of acute and late toxicities. NACT + RT may therefore be a better treatment strategy for ascending? Type NPC.