International Journal of Hematology and Oncology 2019, Vol 29, Num 3 Page(s): 176-185
Neoadjuvant Chemotherapy Improves Survival in Patients with Locally Advanced Nasopharyngeal Carcinoma

Hamit BASARAN1, Mustafa CENGIZ1, Gozde YAZICI1, Nilda SUSULU2, Sercan AKSOY3, Ali Sefik HOSAL2, Ibrahim H. GULLU3, Gokhan OZYIGIT1

1Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara, TURKEY
2Hacettepe University Faculty of Medicine, Department of Otorhinolaryngology, Ankara, TURKEY
3Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, TURKEY

Keywords: Nasopharyngeal Carcinoma, Neoadjuvant chemotherapy, Concomitant Chemoradiotherapy, Survival
This study aimed to evaluate survival in patients with locally advanced nasopharyngeal carcinoma. The records of 407 patients with locally advanced nasopharyngeal carcinoma treated retrospectively reviewed. Patients were treated with 5 different treatment protocols: 22.4% patients received radiotherapy, 16.4% received concomitant chemoradiotherapy, 11.3% received concomitant hemoradiotherapy + adjuvant chemotherapy, 30.7% received neoadjuvant chemotherapy + concomitant chemoradiotherapy, and 19.2% received neoadjuvant chemotherapy + radiotherapy. At the median follow-up of 64 months 5-year and 10-year overall survival were 64.6% and 55.3%, respectively, and 5-year and 10-year locoregional relapse-free survival were 58.5% and 49.2%, respectively. Age <40 years (p< 0.001) and early stage (p= 0.014) were associated with better survival. Among the treatment protocols, neoadjuvant chemotherapy + radiotherapy yielded the best survival (p= 0.001). Concomitant chemoradiotherapy was not associated with any survival advantage; however, the addition of hemotherapy to concomitant chemoradiotherapy prolonged survival, regardless of radiotherapy schedule. The present fndings show that the addition of chemotherapy, especially neoadjuvantly, improved overall survival.