Benefit of Adding Chemotherapy And/Or Modification of Radiotherapy Schedule for Advance Nasopharyngeal Carcinoma (T3-4N0-1M0)

Prospective Randomized Study on Therapeutic Gain Achieved By Chemoradiation And/Or Accelerated Radiation For T3-4N0-1M0 Nasopharyngeal Carcinoma

To test the therapeutic ratio of accelerated radiotherapy and/or chemotherapy on locally advanced nasopharyngeal carcinoma.

Inclusion Criteria:

• Undifferentiated or non-keratinizing carcinoma
• Tumor staged as T3-4 AND N0-1
• No evidence of distant metastasis (M0)
• Performance status: 0-2
• Marrow: WBC >= 4 and platelet = 100
• Renal: creatinine clearance = 60
• Informed consent

Exclusion Criteria:

• WHO type I squamous cell carcinoma or adenocarcinoma
• Age >= 70
• Palliative intent or tumor extent mandating AP opposing facio-cervical fields
• Prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease-free for 5 years
• Previous radiotherapy (except non-melanomatous skin cancers outside the intended RT treatment volume
• Previous chemotherapy
• Patient is pregnant or lactating