Recent perspectives in the role of chemotherapy in the management of advanced nasopharyngeal carcinoma.

BACKGROUND: Recent advances in the treatment of nasopharyngeal carcinoma (NPC) have transpired into better treatment outcomes for patients with locoregionally advanced NPC, and have broadened the chemotherapeutic options for patients with metastatic disease.

METHODS: Data for this review were identified through searches of articles published in PubMed, MEDLINE, and abstracts from selected conference proceedings up to 2004.

RESULTS: The results of two meta-analyses and at least six randomized trials supported a survival benefit with the use of concurrent chemotherapy (e.g., platinum, tegafur-uracil [UFT)] and standard fractionated radiotherapy (with or without adjuvant chemotherapy) in the management of patients with locoregionally advanced NPC (nonmetastatic Stage III/IV disease, according to the staging system of the International Union Against Cancer). For those patients with metastatic NPC, platinum-based doublets using newer agents such as gemcitabine and the taxanes are reported to be better tolerated and can yield response rates comparable to those obtained with older, multidrug regimens.

CONCLUSIONS: The current study reviewed the latest literature and pertinent issues concerning the role of chemotherapy in the treatment of patients with metastatic and locoregionally advanced NPC.