Multicenter phase 3 study of sequential versus induction plus concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma

Induction chemotherapy (IC) plus concurrent chemoradiotherapy (CCRT) is a standard treatment for locoregionally advanced nasopharyngeal cancer (LA-NPC) but with high acute toxic effects in the CCRT phase. A multicenter randomized noninferiority phase 3 trial in China compared IC+CCRT versus IC + radiotherapy plus adjuvant chemotherapy for LA-NPC. In this trial of 420 patients with stage III/IVA NPC who received radiotherapy plus adjuvant chemotherapy or chemoradiotherapy after induction chemotherapy, the 3-year failure-free survival rate was 83.7% and 79.5%, respectively. The incidence of grade 3 or higher acute nonhematological toxic effects was significantly lower in the radiotherapy plus adjuvant chemotherapy group.