Intraarterial Infusion Chemotherapy Combined With Three-dimensional Conformal Radiotherapy For Local Advanced Nasopharyngeal Carcinoma

Objective:To evaluate the clinical significance of intraarterial infusion chemotherapy before radiotherapy for patients with local advanced nasopharyngeal carcinoma(NPC)Methods:253 patients with stageâ…¢,â…£a NPC were assigned to receive either cisplation(DDP)+5-fluorouracil(5-Fu)+bleomycin(PYM) intraarterial chemotherapy through ascending pharyngeal artery or superior maxillary artery with Seldinger's method(therapy group,n=103),or i.v. DDP+5-Fu+PYM(control group,n=150).Both the two groups received ⁶⁰Co-γRadiotherapy with the same time and dose splitting one week after the second cycle of chemotherapy.Results:After intraarterial infusion chemotherapy,the primary tumor mass reduced in size and the enlarged cervical lymph nodes shrank or became loosened in all 103 patients.At 3～6 months following completion of radiotherapy,the short-term total remission rate of the therapy group and the control group were 84.47%and 73.33%,respectively.The difference between the two groups was significant(P＜0.05).The overall 1-,3-year survival rate were 94.17%(97/103),75.73%(78/103)in the therapy group,and 92.67 %(139/150),57.33%(86/150)in the control group,respectively.The difference of 1-year survival rate between the two groups was not statistically significant(P＞0.05).But the difference of 3-year survival rate between the two groups was statistically significant(P＜0.05).The median survival time was 49.17 months in the therapy group and 42.61 months in the control group respectively.The difference between the two groups was significant(P＜0.05). No severe side-effects and complications found.The major adverse effects were alopecia and mucositis in therapy group and gastrointestinal troubles in control group.Conelusion:Intraarterial infusion chemotherapy before radio-therapy is an effective treatment for patients with stageâ…¢,â…£a NPC,without inflicting more treatment-related toxicities.