Oxaliplatin improves outcomes in patients with advanced nasopharyngeal carcinoma

Adding oxaliplatin to standard radiotherapy improves outcomes in patients with locoregionally advanced nasopharyngeal carcinoma, according to a report in the November 20th Journal of Clinical Oncology.

Although concurrent chemoradiotherapy for nasopharyngeal carcinoma is standard practice in North America, the authors explain, it remains unclear whether this is the best treatment for WHO subtype III undifferentiated nasopharyngeal carcinoma, the most common histology in southern China.Dr. Li Zhang and colleagues from Cancer Center of Sun Yat-Sen University, Guangzhou, People’s Republic of China compared standard radiotherapy with or without weekly oxaliplatin in the treatment of locoregionally advanced nasopharyngeal carcinoma in 115 patients.The rate of complete response with concurrent chemoradiotherapy was 83%, the authors report, compared with 66% with radiotherapy alone.Concurrent chemoradiotherapy was associated with a two-year overall survival rate of 100%, the results indicate, compared with 77% in the radiotherapy treatment arm.Relapse-free survival and metastasis-free survival were also higher in the concurrent chemoradiotherapy group (96% and 92%, respectively) than in the radiotherapy-only group (83% and 80%, respectively), the researchers note.Treatment with concurrent chemoradiotherapy was associated with a higher incidence of leukopenia, nausea and vomiting, and peripheral neuropathy, the report indicates.Late toxicities, including xerostomia, skin reaction, mucositis, and dysphagia, were similar between the two treatments, the investigators observe.”The results of our study strongly support the superior efficacy of concurrent chemoradiotherapy,” the authors conclude. “Concurrent chemoradiotherapy with oxaliplatin weekly is feasible and improves the overall survival, relapse-free survival, and metastasis-free survival rates in patients with locoregionally advanced nasopharyngeal carcinoma.””Furthermore,” the researchers add, “our trial is the first to demonstrate an improved overall survival with concurrent chemotherapy with a single drug for locoregionally advanced nasopharyngeal carcinoma patients.”(Source: J Clin Oncol 2005;23:8461-8468: Reuters Health: Oncolink: December 2005.)