Combined chemo-radiotherapy for stage IV undifferentiated nasopharyngeal carcinoma

Undifferentiated nasopharyngeal carcinoma is a chemosensitive lesion, but i ts role in the management of local advanced disease is under investigation. Twenty-seven untreated stage IV undifferentiated nasopharyngeal carcinoma patients were treated with radiotherapy (median dose, 66.6 Gy, 1.8 Gy/day) and concomitant cisplatin (100 mg/m(2) days 1, 22 and 43). After 4 weeks, p atients received, every 4 weeks, 3 cycles with cisplatin (80 mg/m(2) day 1) h+ 5-fluorouracil (1000 mg/m(2)/day continuous infusion for 96h). After rad iotherapy, we observed 74% complete responses and 26% partial responses; af ter adjuvant chemotherapy 96% had a complete and 4% a partial response. Aft er a median follow-up of 36 months, 81% of the patients were alive (70% wit h no evidence of disease). Four-year overall and disease-free survival was 70% and 60%, respectively. Concomitant chemotherapy plus radiotherapy was w ell tolerated, whereas adjuvant chemotherapy was more toxic, Long-term resu lts were significantly better than those observed with radiotherapy alone.