Neo-adjuvant Docetaxel and Cisplatin followed by concurrent Cisplatin with radiation therapy in treatment of locally advanced nasopharyngeal carcinoma.

AIM OF THE STUDY To assess the tolerability, toxicity and efficacy of neo-adjuvant Docetaxel and Cisplatin (TC) followed by concurrent Cisplatin and radiotherapy (RT) in patients with loco-regionally advanced nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS Fourteen patients with locally advanced NPC received two cycles of Docetaxel (75 mg/m2 on days 1, and 21) and Cisplatin (75 mg/m2 on days 1, and 21) followed by 7 weeks of Cisplatin (40 mg/m2 weekly) and RT at 70 Gy in 2-Gy per fraction. RESULTS Response to neo-adjuvant TC was as follows: 5 patients (36%) and 11 patients (79%) achieved partial remission (PR) in regional nodes and nasopharynx, respectively. Nine patients (64%) and 1 patient (7%) achieved complete remission (CR) in regional nodes and nasopharynx, respectively. At 6 weeks after RT, 12 patients (86%) achieved CR in regional nodes and nasopharynx, and 2 patients (14%) achieved partial response (PR) in regional nodes and nasopharynx. Neo-adjuvant TC was well tolerated. The most common acute toxicity of Cisplatin plus Docetaxel was grade 3-4 leucopenia (57%) and alopecia (43%). The most common acute toxicity of Cisplatin plus RT was grade 3-4 mucositis (64%). At median follow-up of 12 months, one distant and one loco-regional failure occurred. CONCLUSIONS Neo-adjuvant Docetaxel and Cisplatin (TC) followed by concurrent Cisplatin and radiotherapy (RT) in patients with loco-regionally advanced nasopharyngeal carcinoma (NPC) was feasible and resulted in excellent local tumour control with acceptable toxicity profile.