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

Objective: 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).

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.