Induction Chemotherapy in Young Patients With Locoregionally Advanced Nasopharyngeal Carcinoma

Inclusion Criteria:

• Patients with newly histologically confirmed non-keratinizing (according to WorldHealth Organization (WHO) histologically type).

• Original clinical staged as T4N0-3 M0 or any T、N3M0（according to the American JointCommittee on Cancer(AJCC) 7th edition）

• No evidence of distant metastasis (M0).

• Age ≤ 18 years old.

• Satisfactory performance status: Karnofsky scale (KPS) > 70.

• Adequate marrow: leucocyte count ≥4000/μL, hemoglobin ≥90g/L and platelet count ≥100000/μL.

• Normal liver function test: Alanine Aminotransferase (ALT)、Aspartate Aminotransferase (AST) <1.5×upper limit of normal (ULN) concomitant with alkaline phosphatase (ALP) ≤2.5×ULN, and bilirubin ≤ULN.

• Adequate renal function: creatinine clearance ≥60 ml/min.

• Patients must be informed of the investigational nature of this study and give writteninformed consent.

Exclusion Criteria:

• WHO Type keratinizing squamous cell carcinoma or basaloid squamous cell carcinoma.

• Age >18 years.

• Treatment with palliative intent.

• Prior malignancy except adequately treated basal cell or squamous cell skin cancer, insitu cervical cancer.

• Pregnancy or lactation.

• History of previous radiotherapy (except for non-melanomatous skin cancers outsideintended RT treatment volume).

• Prior chemotherapy or surgery (except diagnostic) to primary tumor or nodes.

• Any severe intercurrent disease, which may bring unacceptable risk or affect thecompliance of the trial, for example, unstable cardiac disease requiring treatment,renal disease, chronic hepatitis, diabetes with poor control (fasting plasma glucose >1.5×ULN), and emotional disturbance.