Man Xu, Shuting Yang, Erying Cui, Zheng Wang, Xuqi Li , 2025-04-15 09:52:00
- Man Xu, associated professor1 2,
- Shuting Yang, doctor1 3,
- Erying Cui4,
- Zheng Wang, professor3,
- Xuqi Li, professor1
- 1Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi, China
- 2Department of Radiation Oncology, Xi’an Gaoxin Hospital, Xi’an, Shaanxi, China
- 3Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
- 4Patient author, Shaanxi, China
- Correspondence to: X Li lixuqi{at}163.com
Nasopharyngeal carcinoma (NPC) is an epithelial malignancy that is associated with the Epstein-Barr virus and is characterised by distinct epidemiological patterns that are prevalent in China, Southeast Asia, and north Africa.1 In early stage NPC, excellent outcomes have been achieved with radiotherapy alone. The application of intensity modulated radiotherapy has increased locoregional control and overall survival rates at five years to over 90% in these patients.23 However, more than 70% of patients receive NPC diagnoses at a locally advanced stage.4 Despite the technological advances in intensity modulated radiotherapy, the treatment of locally advanced NPC still relies on the combination of chemotherapy and radical radiotherapy.
Neoadjuvant chemotherapy, alternatively termed induction chemotherapy, involves the administration of chemotherapy for NPC before the initiation of radiotherapy. Concurrent chemoradiotherapy for NPC is a therapeutic approach that entails the simultaneous application of chemotherapy agents and radiotherapy.5 In the era of intensity modulated radiotherapy, neoadjuvant chemotherapy combined with concurrent chemoradiotherapy (CCRT) has been identified as a strategic approach to enhance survival outcomes in patients with locally advanced NPC; however, previous clinical trials have generated conflicting evidence.678 In a linked study (doi:10.1136/bmj-2024-081557), Xie and colleagues conducted a phase 3 multicentre trial to determine the optimal induction regimens …