Needs an induction.

In 2019, a randomized phase 3 trial demonstrated that induction chemotherapy with gemcitabine and cisplatin followed by chemoradiation for locoregionally advanced nasopharyngeal carcinoma (NPC) significantly improved 3-year recurrence free survival (85.3% v 76.5%) and overall survival (94.6% v 90.3%) compared to chemoradiation alone. Here is the final analysis of 5 year overall survival, which remained significantly better with induction chemo (87.9% v 78.8%). Response to induction therapy was strongly associated with OS, which was 100% in complete responders, 88.4% in partial responders, and 61.5% in those with stable or progressive disease. In contrast, there was no difference in OS among those with a low pre-treatment EBV level (<4000 copies). | Zhang, J Clin Oncol 2022