Survival Benefits of Patients with Nasopharygneal Carcinoma (Stage III) who Received Chemoradiotherapy with Weekly Low Dose Oxaliplatin in Comparison to those Received Radiotherapy Alone in Mansoura University Hospital

Background: Nasopharyngeal carcinoma (NPC) is a tumor arising from epithelium of nasopharynx. NPC can be divided into three different histological types: Keratinizing squamous cell carcinoma (WHO type I), non keratinizing squamous cell carcinoma (WHO type II) which is more aggressive, and undifferentiated carcinoma (WHO type III) with more frequent lymphatic and hematogenic spread. NPC usually manifest in advanced stage but it is more chemosensitive than other head and neck tumors. Adding concurrent oxaliplatin to radiotherapy in patient with locoregional advanced NPC is point of interest of this study. Patients and Methods: 70 Patients with non-keratinizing/ undifferentiated locoregionally advanced NPC with medical contraindications to receive cisplatin therapy (Diabetic neph-ropathy, collagen vascular or renal diseases) were randomly selected from Clinical Oncology and Nuclear Medicine Department Faculty of Medicine Mansoura University from Jan. 2007 – Jan. 2008, to receive either radiotherapy (RT) alone (n=40) or RT plus concurrent oxaliplatin in a dose of 35 mg/m2 weekly for six cycles (n=30). Results: After a median follow-up of 39 months (range 18-60 months), the 5-year overall survival (OS) and metastasis-free survival MFS, rates in the concurrent chemoradiotherapy (CCRT) group were significantly higher than those observed in the RT-alone group (OS, 89.6% versus 67.6%, p=0.028; MFS, 74.7% versus 63.0% p=0.027). However, CCRT did not improve locoregional failure survival significantly. Subgroup analyses showed that the superiorities of CCRT mainly existed in the T3-4N0-1 stage subgroup (OS: HR=0.394, p=0.034). The grade 3 late toxic effects were more or less similar in the two groups (p=0. 10). Conclusion: Follow-up data confirm the role of CCRT as a treatment of locoregiorally advanced NPC. Oxaliplatin can be considered as an alternative optional therapeutic regimen for these patients due to its high efficiency and low toxic effect.