Treatment Outcomes of Alternating Chemoradiotherapy for Nasopharyngeal Carcinoma

[Abstract] Purpose: The aim of this study was to analyze the treatment outcomes of alternating chemoradiotherapy (ACRT) for nasopharyngeal carcinoma (NPC) and to assess the safety and efficacy of this treatment. Materials and Methods: Twelve patients with stage II-IVB NPC were treated with ACRT in our hospital between 2005 and 2011. The radiotherapy period was divided into two components. In the first half, patients received 36 Gy to the whole neck field. In the second half, patients received 30～34.2Gy to the shrinking field to the primary and involved lymph nodes. A course of chemotherapy comprised of fluorouracil at a dose of 800 mg/m2/day was administered for 5 days (day 1-5), and cisplatin at 50 mg/m2/day was administered for 2 days (day 6-7). A total of three courses of chemotherapy were performed systemically before starting radiotherapy, after completing the first half of radiotherapy and after completing the second half of radiotherapy. Results: The planned radiation dose was achieved for all patients. Ten of the 12 patients completed the three courses of chemotherapy as planned. The remaining two patients completed only two courses because they refused, not due to adverse events. The five-year overall survival rate was 83%, the progression-free survival rate was 67%, the locoregional progression-free survival rate was 75%, and the distant-metastasis free survival rate was 92%. With regard to acute adverse events, the incidence of grade >=3 hematotoxicity was 33%, and the nonhematotoxicity event was only one case of grade 3 mucositis. No late adverse events of grade >=3 occurred. Conclusion: ACRT offered an excellent completion rate and could be safely conducted. Although a limited numbers of subjects were considered in this study, the outcomes of ACRT were favorable in terms of safety and efficacy.