Chemotherapy plus radiotherapy makes curability a possibility in nasopharyngeal carcinoma patients with distant metastasis at diagnosis

Abstract Background Systemic chemotherapy is the major treatment for nasopharyngeal carcinoma (NPC) patients with distant metastasis at diagnosis. Addition of radiotherapy has not been explored in these patients. Methods We retrospectively analysed 226 NPC patients with distant metastasis at diagnosis who received chemotherapy alone or chemotherapy plus radiotherapy. Survival was analysed using Kaplan–Meier analysis and the logrank test. Results Median follow-up was 65.5 months (range, 27–113 months). Median overall survival (OS) was 16 months (95% CI, 14.3–17.7) for the chemotherapy group and 36 months (26.9–45.1) for the chemotherapy plus radiotherapy group (P < 0.001). Median progression-free survival (PFS) was 7 months (4.9–9.1) for the chemotherapy alone group and 28 months (18.2–37.8) for the chemotherapy plus radiotherapy group (P < 0.001). Cox multivariate analysis indicated that chemotherapy regime (paclitaxel plus cisplatin-based regimens vs. other cisplatin-based regimens) and radiotherapy were independent prognostic factors. Conclusions Adding radiotherapy to four to six cycles of paclitaxel-based chemotherapy significantly improved PFS and OS in distant metastatic NPC patients. Chemotherapy plus radiotherapy makes curability a possibility in these patients.