Treatment Responses of Pakistani Nasopharyngeal Carcinoma Patients Treated with Induction Chemotherapy Followed by Concurrent Chemoradiotherapy

Abstract

Objective: To investigate the response of nasopharyngeal cancer patients to induction chemotherapy, followed by concurrent chemoradiation, in our patient population.
Study Design: Retrospective cohort study
Place and Duration: Institute of nucleal medicine and oncology Lahore (INMOL) and Combined Military Hospital (CMH) Rawalpindi over a period of 5 months (Between Aug 2023 to Dec 2023) on patients treated between January 2015 to Dec 2019 (5 years).
Methodology: A total of 125 patients of proven nasopharyngeal squamous cell carcinomas were treated with 3 cycles of induction chemotherapy cisplatin and 5-fluorouracil followed by concurrent chemoradiotherapy (CCRT) with weekly cisplatin to 70 Gy in 35 daily fractions over 7 weeks. Response was evaluated at 4-6 weeks of treatment completion by RECIST 1.1 criteria.
Results: Male to female ratio was 3.46:1. Mean age of the patients was 37.3 years. Majority of the patients had stage III, IVA and IVB being 36.0%, 36.0% and 20.8% respectively. Grade III (n=79, 63.2%) was commonly observed grade. There was complete response (CR) in 51.2% while 30.4% showed partial response (PR). Stable and progressive disease was observed in 8.0% and 10.4% patients respectively. A CR of 100% in stage I, 57.1% in stage II, 82.2% in stage III and 46.7% in stage IV patients. Gender wise treatment response was 53.6% CR in males and 42.9% in females (p= 0.691).
Conclusion: Induction chemotherapy followed by concurrent chemoradiation has good response rates, and can be used as treatment of choice for definitive management of advanced nasopharyngeal cancer patients