title: [Induction chemotherapy followed by chemoradiotherapy for the patients with far-advanced nasopharyngeal carcinoma - our treatment strategy].
abstract: Nasopharyngeal carcinoma(NPC)is a rare malignant neoplasm arising from the head and neck region that affects less than 1 per 100, 000 in the Japanese population. NPC is a highly radiosensitive and chemosensitive cancer when compared to other head and neck cancers. Its treatment has mainly been developed by using radiotherapy and chemotherapy, rather than surgery. The standard of care now calls for radiotherapy alone for early-stage patients, and chemoradiotherapy for the advanced stages. Despite its sensitivity to treatments, survival rates of patients with Stage IV A, IV B, N 2/3 have been inadequate. The effectiveness of triplet-regimen induction chemotherapy for patients with locally advanced head and neck cancer has recently been reported. Since 2009, we have tried to improve survival by treating patients with triplet-regimen induction chemotherapy consisting of docetaxel, cisplatin and S-1, followed by cisplatin-based chemoradiotherapy. This treatment strategy has dramatically improved both overall survival and the complete response rate. Although it is a very promising treatment, it is highly toxic at the same time. We have experienced more than a few hematological and non-hematological grade 3/4 toxicities. Therefore, when conducting a treatment, considering its indication and building a sufficient back-up system are very important.
authors.affiliation: Division of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ishiki
authors.forename: Makoto
authors.initials: M
authors.lastname: Tahara
mesh_terms: D002277:Carcinoma; D059248:Chemoradiotherapy; D006801:Humans; D060828:Induction Chemotherapy; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D009367:Neoplasm Staging; D011379:Prognosis