[Combined induction chemotherapy and radiotherapy in case of undifferentiated carcinoma of nasopharynx tumours (UCNT)].

OBJECTIVE

The objectives of our study were to consider the morbidity and the effectiveness of combined induction chemotherapy and radiotherapy in the treatment of Undifferentiated Carcinoma of Nasopharynx Tumor (UCNT).

PATIENTS AND METHODS

It was a retrospective study (1987-2002) of patients who had not received any previous treatment. Patients with distant metastases during initial assessment were excluded. Two types of chemotherapy were administered: The BAC regime (Bleomycin, Adriamycin, Cisplatinum) and the FUCIFOL regime (Fluorouracil, Cispaltinum, Elvorin). The protocol for radiotherapy was either radiotherapy alone or concomitant chemoradiotherapy. The survival rates were calculated with the nonparametric method of Kaplan-Meier and compared with logrank tests. The multivariate analysis were made with the regressive logistic method.

RESULTS

Fourty four patients (32 males, 12 females), average age 46 years (14-77) were selected. On the whole, the tolerance of the treatment was good (chemotherapy 71%, radiotherapy 82%). Treatment mortality was null. The BAC regime was the most effective. At the end of the treatment, a total response was obtained in 82% of cases. The commonest cause of treatment failure was the emergence of metastases (64% of deaths). The overall disease free survival rates at 3 years were respectively 78% and 69%. With multivariate analysis, the independent variables inductive radiotherapy and the initial response to treatment were significantly linked to death with a respective p value of 0.02 and 0.0084.

CONCLUSIONS

Combined induction chemotherapy and radiotherapy is efficient in the treatment of UCNT. The tolerance of treatment was good. Our results are comparable with those reported in the literature.