Nineteen previously untreated metastatic NPC patients received one to six cycles of docetaxel and cisplatin. Fifteen patients received at least three cycles. The starting dose was 75 mg/m
2 every three weeks for both drugs in 15 patients, and 60 mg/m
2 for both drugs in four patients. All patients were included in toxicity and survival analysis, and 16 patients were evaluable for response. Median follow-up time was 11.6 months.
Hematological toxicity was severe with Grade 4 neutropenia in 78.9 % patients and 51.3 % cycles. Febrile neutropenia occurred in 42 % patients and 12.5 % cycles, with two septic deaths in the population treated with 75 mg/m2. Patients treated with a dose subsequently reduced to 60 mg/m2 had a lower incidence of Grade 4 neutropenia and no incidence of neutropenic fever/sepsis. Overall response rate was 62.5 % , with a 95 % confidence interval of 35–85 % . Partial and complete response rates were 56.3 % and 6.3 % , respectively. Median time to progression was 5.6 months and median survival was 12.4 months. Three patients (15.6 % ) survived >2 years following chemotherapy.
The combination of docetaxel and cisplatin is active in metastatic NPC. The dose of 60 mg/m2 for both drugs without colony-stimulating factor support should be further evaluated as a high incidence of febrile neutropenia was observed with 75 mg/m2 dose.
