Original Investigation

Sequential vs Induction Plus Concurrent Chemoradiotherapy in Nasopharyngeal Carcinoma

JAMA Oncology 10.1001/jamaoncol.2025.2191

July 24, 2025 at 11:00 AM EDT

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For the treatment of locoregionally advanced nasopharyngeal carcinoma after induction chemotherapy, is radiotherapy plus adjuvant chemotherapy noninferior to concurrent chemoradiotherapy?In this noninferiority randomized clinical trial of 420 individuals with stage III/IVA nasopharyngeal cancer who received radiotherapy plus adjuvant chemotherapy or chemoradiotherapy after induction chemotherapy, the 3-year failure-free survival rate was 83.7% and 79.5%, respectively. The noninferiority margin of a less than 10% margin was met.The results of this trial suggest that after induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma, radiotherapy plus adjuvant chemotherapy was noninferior to chemoradiotherapy in terms of 3-year failure-free survival.

Corresponding Authors: Xiayun He, MD (hexiayun1962@163.com), and Chaosu Hu, MD (hucsu62@163.com), Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong An Rd, Shanghai 200032, China.

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