Objectives: To investigate the role of Induction Chemotherapy (IC) followed by Concurrent Chemo Radiation (CCRT) and Concurrent Chemo Radiation (CCRT) followed by Adjuvant Chemotherapy (AC) in Locally Advanced Nasopharyngeal Carcinoma (LANPC). 

Material and Methods: Locally Advanced Nasopharyngeal Carcinoma (LANPC) patients were enrolled in the study from October 2016 to June 2022. Study variables were well balanced using the Propensity Score-Matched (PSM) method. Independent prognostic factors were identified using Cox regression analysis, and the outcome between the two chemotherapy treatment combinations was compared for patients in different subgroups. 

Results: A total of 80 patients were included in the study. Survival outcomes indicated that the Induction Chemotherapy followed by Concurrent Chemo Radiation (IC +CCRT), group achieved a higher 5-year Overall Survival (OS; 90% vs. 81% P = 0.253), failure-free survival (FFS; 80% vs. 77.50% P = 0.17) and Distant Metastasis-Free Survival (DMFS; 88% vs. 82.50% P = 0.314) compared with concurrent chemo radiation followed by adjuvant chemotherapy (CCRT +AC) group, although it was not statistically significant. The stratified analysis revealed that Induction Chemotherapy followed by Concurrent Chemo Radiation (IC +CCRT), was associated with significantly improved OS ((HR = 0.212, 95% CI = 0.014-3.16; P = 0.0026) in N2 disease. However, the superiority of concurrent chemo radiation (CCRT), followed by Adjuvant Chemotherapy (AC), was only observed in LRRFS (HR = 0.45, 95%CI=0.05-0.89; P=0.036) for the T4 subgroup. 

Conclusion: Induction Chemotherapy (IC) followed by Concurrent Chemo Radiation (CCRT) should be strongly considered for patients with locally advanced Nasopharyngeal Carcinoma (NPC), especially with T3 or N2 disease.

Kaneez Fatima is 41 years old and she has done her MBBS from Govt Medical College Srinagar in 2007. She completed her MD Radiation Oncology from Shri Kashmir Institute of Medical Sciences Srinagar in year 2013. She completed her 3 years senior Residency in Sheri Kashmir Institute of Medical Sciences till 2016. Then she was appointed as lecturer in Govt medical college Srinagar in 2016. Later, she was appointed as assistant professor in 2018 in Sheri Kashmir Institute of Medical Sciences. Presently working as associate professor in Sheri Kashmir Institute of Medical Sciences with 10 years’ experience in oncology.