title: Is Gemcitabine and Cisplatin Induction Chemotherapy Superior in Locoregionally Advanced Nasopharyngeal Carcinoma?
abstract: OBJECTIVE
  To investigate the outcome of locoregionally advanced nasopharyngeal carcinoma (NPC) treated with induction chemotherapy followed by chemoradiotherapy.
  
  
  METHODS
  Between June 2005 and October 2007, 604 patients with locoregionally advanced NPC were analyzed, of whom 399 and 205 were treated with conventional radiotherapy and intensity-modulated radiotherapy (IMRT) respectively. Meanwhile, 153 patients received concurrent chemotherapy, and 520 were given induction chemotherapy.
  
  
  RESULTS
  With a median follow-up time of 65 months, the 3-, and 5-year overall survival (OS), locoregional free survival (LRFS), and distant-metastasis free survival (DMFS) rates were 82.5% vs. 72.6%, 90.6% vs. 87.1%, and 82.5% vs. 81.2%, respectively. Induction chemotherapy was not an independent prognostic factor for OS (P=0.193) or LRFS, but there was a positive tendency for DMFS (P=0.088). GP regimen (gemcitabine + cisplatin) was an independent prognostic factor for OS (P = 0.038) and it had a trend toward improved DMFS (P = 0.109). TP regimen (taxol + cisplatin) was only a significant prognostic factor for DMFS (P =0.038).
  
  
  CONCLUSIONS
  Adding induction chemotherapy had no survival benefit, but GP regimen benefited overall survival and had a trend toward improved DMFS. GP regimen may be superior to TP/FP regimen (fluorouracil + cisplatin) in treating locoregionally advanced NPC.
authors.affiliation: Wei Zheng, Department of Radiation Oncology, Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China. Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China. Teaching Hospital of Fujian Health College, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.affiliation: Sufang Qiu, Department of Radiation Oncology, Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China. Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China. Teaching Hospital of Fujian Health College, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China.
authors.forename: Sufang
authors.initials: S
authors.lastname: Qiu
authors.affiliation: Lingling Huang, Department of Radiation Oncology, Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China. Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Huang
authors.affiliation: Jianji Pan, Department of Radiation Oncology, Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China. Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China. Teaching Hospital of Fujian Health College, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China.
authors.forename: Jianji
authors.initials: J
authors.lastname: Pan
keywords: Induction chemotherapy; Nasopharyngeal carcinoma; Radiotherapy