Background:
Recurrent undifferentiated nasopharyngeal carcinoma (unpc) is a chemosensitive illness. here we report long-term results of high-dose chemotherapy (hdc) as late intensification, with autologous peripheral blood stem cell (pbsc) support.
Methods:
Six patients (5 men, 1 woman; median age 41years; median ecog ps = 0) with recurrent unpc (local, 2; local + nodal, 2; bone metastasis, 2) have been enrolled. all patients had been previously treated with neoadjuvant chemotherapy and radiotherapy; 3 of 4 local relapses had received a re-irradiation. every patient received three courses of cisplatin + epirubicin and 1 cycle of epirubicin followed by pbsc collection. a median of 7.2 x 10(6)/kg (range, 4.5-18) cd34+ cells were reinfused. hdc was according ice scheme: ifosfamide, 2.5 g/m(2)/d, + carboplatin, 300 mg/m(2)/d, + vp-16, 300 mg/m(2)/d days 1 through 4.
Results:
After conventional chemotherapy, we had 1 cr (16%), 3 pr (50%), and 2 nc (34%). after hdc, we had 4 cr (66%),1 pr (17%), and 1 mr (17%). toxicity was manageable. after a median follow-up of 30 months (range, 14-50), two patients are alive without disease (34%), one is alive with bone disease (16%), and three (50%) died of disease at 16, 18, and 24 months.
Conclusions:
Hdc has an acceptable toxicity, can convert pr in cr, and seems effective, with long-lasting crs.