Randomized Trial to Evaluate the Therapeutic Gain by Changing the Chemoradiotherapy From Concurrent-adjuvant to Induction-concurrent Sequence, and the Radiotherapy From Conventional to Accelerated Fractionation for Advanced Nasopharyngeal Carcinoma
- Histologically proven nasopharyngeal carcinoma
- Non-keratinizing or undifferentiated type Stage III-IVB (by AJCC/UICC 6th edition)
- Essential staging investigations: CT or MRI of nasopharyngeal region Chest x-ray (or
- Liver function test, alkaline phosphatase Liver and bone scan if alkaline phosphatase
exceeds the institutional upper limit of normal, or if clinically indicated.
- Liver scan if SGOT exceeds the institutional upper limit of normal
- Adequate marrow: WBC > 4 and platelet > 100
- Adequate renal function: creatinine clearance > 60 ml/min.
- Satisfactory performance status: > 2 by ECOG System.
- WHO Type I squamous cell carcinoma or adenocarcinoma
- Age > 70
- Treatment with palliative intent (including those with tumor extent mandating the use
of AP opposing facio-cervical field technique)
- Prior malignancy except adequately treated basal cell or squamous cell skin cancer,
in-situ cervical cancer, or other cancer for which the patient has been disease-free
for five years.
- Pregnancy or lactation (consider pregnancy test in women of child-bearing age and
emphasize effective contraception during the treatment period).
- History of previous RT (except for non-melanomatous skin cancers outside intended RT
- Prior chemotherapy or surgery (except diagnostic) to primary tumor or nodes.