Abstract: Objective To evaluate the efficacy of concurrent chemoradiotherapy combined with adjuvant chemotherapy on the patients with nasopharyngeal carcinoma(NPC)at stage III-IVa.Methods 108 patients with NPC at stage III-IVa were randomly divided into two groups.Test group(n=54)was treated with DDP 30mg/m2 and 5-FU 750mg/m2 on day 1-3;radiotherapy started 1-3 days after the end of first phase chemotherapy;the next two phases of chemotherapy were from 5th-week to the end of radiotherapy;adjuvant chemotherapy were performed after 1-4 weeks at the end of radiotherapy and repeated for 2 cycles.Control group(n=54)was treated only with conventional radiotherapy.Results The 5-year overall survival rate and disease-free survival rate were significantly higher in test group than that in control group(63.0% vs 42.6%,61.1% vs 38.9%,P<0.05).The rate of distant metastasis was significantly lower in test group than that in control group(18.5% vs 37.0%,P<0.05).Among the patients at stage N3,the rates of distant metastasis in test group and control group were 57.1%(4/7)and 66.7%(4/6)respectively(P=1.000).The test group experienced significantly more mucositis than that in control group(48.1% vs 27.8%,P<0.05).Conclusions Concurrent chemoradiotherapy combined with adjuvant chemotherapy could improve the 5-year overall survival rate and disease-free survival rate of NPC patients at stage III~IVa,and could reduce the rate of distant metastasis except the patients at stage N3.

Key words: Nasopharyngeal carcinoma, Concurrent chemoradiotherapy, Adjuvant chemotherapy