Poorly differentiated loco-regionally advanced naso – and oropharyngeal carcinoma: results of neoadjuvant chemotherapy followed by radiotherapy

Abstract

Over the years 1986–1997, at the Centre of Oncology in Kraków, 82 patients (28 women, 54 men; mean age: 50.8 years) with poorly differentiatied naso- and oropharyngeal carcinoma with metastases to regional nodes (stage III and IV) received neoadjuvant chemotherapy followed by teleradiotherapy. The primary tumour was located in the nasopharynx in 57 patients (69.5%), in the tonsil – in 24 (29.3%), and in the base of the tongue (one patient). Chemotherapy cycles consisted of cisplatin in a dose of 100 mg/m² administered intravenously on the first day, and 5-f1uorouracil in a dose of 1000 mg/m² over days 1 to 5. Forty-seven (57.3%) patients received 3 cycles, 25 (30.5%) patients – 2 cycles, 8 (9.8%) patients – 1 cycle. After chemotherapy, patients received conventionally fractionated (200 cGy 5x a week) radiotherapy to the primary tumour (50–65 Gy) and regional nodes (50–70 Gy). The therapy was generally well tolerated, however two patients developed fatal late complications. Improvement in therapy results was observed when comparised with a historical group. Five-year overall survival was 52%. The degree of regression (PR + CR), following neoadjuvant chemotherapy, which appeared to depend on the number of chemotherapy cycles, is the main prognostic factor for this group of patients.