Benefit of Adding Chemotherapy for Advance Nasopharyngeal Carcinoma (T1-4N2-3M0)

Prospective Randomized Study on Therapeutic Gain Achieved By Addition of Chemotherapy for T1-4N2-3M0 Nasopharyngeal Carcinoma

To test the therapeutic ratio of additional chemotheray on advanced nasopharyngeal carcinoma.

Inclusion Criteria:

• Undifferentiated or non-keratinizing carcinoma
• Tumor staged as N2-3
• 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