NEOADJUVANT CHEMOTHERAPY FOLLOWED BY CONCURRENT CHEMORADIOTHERAPY FOR LOCOREGIONALLY ADVANCED NASOPHARYNGEAL CARCINOMA: THE NATIONAL INSTITUTE OF ONCOLOGYS EXPERIENCE, RABAT, MOROCCO

Purpose/Objective: Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy (NAC-CCRT) is a standard strategy for decreasing tumor size and controlling micrometastases before main treatment for patients with locally advanced nasopharyngeal carcinoma. The aim of our study is to determine the recurrence free survival and overall survival, and to investigate the occurrence of radiotherapy-induced mucositis and radiodermatitis in patients with nasopharyngeal carcinoma, as well as to identify factors influencing mucositis severity and patient outcomes.

Material/Methods: A retrospective analysis was conducted on nasopharyngeal cancer patients treated with VMAT (Volumetric Modulated Arc Therapy) at the Institute of Oncology RABAT between January 2018 and December 2021. Treatment included radiotherapy with or without concurrent systemic therapy. Our study focused on non metastatic patients with locoregionally advanced nasopharyngeal carcinoma: T3-T4 with positive nodes. Treated by induction chemotherapy and concurrent chemoradiotherapy . For the induction chemotherapy, patients received cisplatin associated to gemcitabine for three cycles. In concurrent chemoradiotherapy, total dose was 69,96-70 Gray in 33-35 fractions 5 days a week using Volumetric Modulated Arc Therapy (VMAT) plus cisplatin weekly at a dose of 40 mg per square meter of body surface. Treatment, side effects, loco-regional and distant control and overall survival were collected. Toxicites were defined according to the common terminology criteria for adverse events ( CTCAE) version 5.0. Patients were under weekly surveillance.