TPC Versus GP Induction Chemotherapy for Nasopharyngeal Carcinoma

Inclusion criteria

• Age between 18 and 65 years;
• Pathologically confirmed differentiated non-keratinizing carcinoma and undifferentiated non-keratinizing carcinoma (WHO type II or III);
• Staged as T4N0-3M0 or T1-4N2-3M0 (UICC 8th edition);
• Easte Cooperative Oncology Group performance status of 0 or 1;
• Adequate bone marrow: leucocyte count ≥ 4×109/L, hemoglobin ≥ 90g/L and platelet count ≥ 100×109/L;
• Adequate hepatic function: Total bilirubin ≤ 1.5 x upper limit of normal (ULN) and AST or ALT ≤ 1.5 xULN;
• Adequate renal function: creatinine clearance rate ≥ 60 ml/min or creatinine ≤ 1.5× ULN;
• Women of childbearing potential and male participants who are sexually active must agree to use a medically effective means of birth control throughout protocol treatment;
• Patients must be appraised of the investigational nature of the study and provide written informed consent.

Exclusion criteria

• WHO Type keratinizing squamous cell carcinoma or basaloid squamous cell carcinoma;
• Treatment with palliative intent;
• Prior malignancy (except for adequately treated carcinoma in situ of the cervix, or basal or squamous cell carcinoma of the skin);
• History of previous radiotherapy (except for non-melanomatous skin cancers outside intended RT treatment volume);
• Prior chemotherapy or surgery (except diagnostic) to primary tumor or nodes.
• Pregnancy or lactation (consider pregnancy test in women of child-bearing age and emphasize effective contraception during the treatment period);
• Any severe intercurrent disease, which may bring unacceptable risk or affect the compliance of the trial, for example, unstable cardiac disease requiring treatment, renal disease, chronic hepatitis, diabetes with poor control (fasting plasma glucose > 1.5×ULN), and emotional disturbance;
• Prior allergic reaction to the study drug(s) involved in this protocol.