These results suggested that our regimen was almost well tolerated and might be of use in locoregional control of nasopharyngeal cancer. However, it carries some risk of late complications and might be inadequate for preventing distant metastases. A three-dimensional conformal boost irradiation technique and adequate dose intensity chemotherapy might be encouraged. Therefore, strategies which improve locoregional control and eradicate occult systemic disease should be encouraged. To deliver higher radiation doses without increasing normal tissue damage, hyperfractionated radiotherapy would appear to be beneficial.
Nasopharyngeal cancer is known to be highly sensitive to chemotherapy.
To improve both locoregional and distant control, additional use of systemic chemotherapy in a neoadjuvant or concurrent setting has been tried. However, they reported a high incidence of severe acute toxicities with concurrent treatment. Severe toxicity, especially mucositis, might be due to large irradiation portals, which include large areas of mucous membrane in the case of nasopharyngeal cancer. We thought that ACT would avoid severe mucosal toxicity compared with concurrent chemotherapy. Taking into account this background, we had carried out a pilot study of hyperfractionated radiotherapy and ACT on patients with locoregionally advanced nasopharyngeal cancer.