Neoadjuvant chemotherapy improves survival in patients with locally advanced nasopharyngeal carcinoma

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 chemoradiotherapy + 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 chemotherapy to concomitant chemoradiotherapy prolonged survival, regardless of radiotherapy schedule. The present findings show that the addition of chemotherapy, especially neoadjuvantly, improved overall survival.