Induction Versus Adjuvant Gemcitabine/Cisplatin in Locally Advanced Non-metastatic Nasopharyngeal Carcinoma
Status:
Recruiting
Trial end date:
2026-04-30
Target enrollment:
Participant gender:
Summary
The standard of care for locally advanced nasopharyngeal carcinoma is radical
chemoradiation(CRT).Recent advances in radiation techniques and supportive measures resulted
in improvemnent of locoregional control and quality of life.However distant failure is still
the main challenging reason of poor survival
Addition of systemic therapy to concurrent CRT is widely used and accepted as an option to
reduce these failures ,however selection of chemotherapy regimen and timing in relation to
CRT is controversial.
Doublet and triplet chemotherapy regimens using cisplatin and 5FU are throughly investigated
in this setting.Inspite of significant improvement in disease free survival and overall
survival they were poorly tolerated.Hence,minority of patients in the daily practice could
tolerate those studied regimens as propsed.
Recently, in multicenter randomized trial, Zhang and his group investigated gemcitabine and
cisplatin as induction chemotherapy (ICT) added to CRT.It showed improvement in recurrence
free survival and overall survival.More importantly 96.7% of the experimental arm completed
the treatment protocol.
This was further confirmed by an updated network of meta analysis by Bongiovanni et al.Again
the question of "when" is still valid.Our proposal is to compare tolerable regimen in
induction versus adjuvant settings.