Ifosfamide and Doxorubicin Combination Chemotherapy for Recurrent Nasopharyngeal Carcinoma Patients

Background: We assessed the efficacy and toxicity of ifosfamide and doxorubicin combination chemotherapy(CT) regimen retrospectively in Turkish patients with recurrent or metastatic nasopharyngeal carcinoma (NPC)previously treated with platinum-based chemotherapy.
Methods: A total of thirty patients who had receivedcisplatin based chemotherapy/chemoradiotherapy as a primary treatment received ifosfamide 2500 mg/m2 days1-3, mesna 2500 mg/m2 days 1-3, doxorubicin 60 mg/m2 day 1 (IMA), repeated every 21 days. Eligible patientshad ECOG PS< 2, measurable recurrent or metastatic disease, with adequate renal, hepatic and hematologicfunctions.
Results: Median age was 47 (min-max; 17-60). Twenty six (86.7 %) were male. Median cycles ofchemotherapy for each patient were 2 (range:1-6). Twenty patients were evaluable for toxicity and response. Nopatient achieved complete response, with nine partial responses for a response rate of 30.0% in evaluable patients.Stable disease, and disease progression were observed in five (16.7%) and six (20.0%) patients, respectively.Clinical benefit was 46.7%. Median time to progression was 4.0 months. Six patients had neutropenic fever afterIMA regimen and there were one treatment-related death due to tumor lysis syndrome in first cycle of the CT.No cardiotoxicity was observed after CT and treatments were generally well tolerated.
Conclusion: Ifosfomideand doxorubicin combination is an effective regimen for patients with recurrent and metastatic NPC. For NPCpatients demonstrating failure of cisplatin based regimens, this CT combination may be considered as salvagetherapy.