Chemotherapy for Nasopharyngeal Cancer

Chemotherapy (chemo) is the use of anti-cancer drugs to treat cancer. These drugs are most often given into a vein (IV) or by mouth. They enter the bloodstream and reach throughout the body, making this treatment useful for cancers that have spread beyond the head and neck.

Chemo may be used in different situations to treat nasopharyngeal cancer (NPC):

  • Chemo is often used together with radiation therapy as the first treatment for more advanced stages of NPC because some chemo drugs make cancer cells more sensitive to radiation. This treatment is called chemoradiation.
  • Chemo may be given before chemoradiation. This is called induction chemo. Not all doctors agree on using chemo this way.
  • Chemo may also be given after radiation (or after chemoradiation). This is known as adjuvant treatment.
  • Chemo is used for patients whose NPC has spread to distant organs such as the lungs, bones, or liver. It may be used alone or along with radiation.

Doctors give chemo in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Cycles generally last about 3 to 4 weeks. Chemo is often not used for patients in poor health, but advanced age by itself should not keep anyone from getting chemo.

Common chemo drugs for NPC

Cisplatin is the chemo drug used most often to treat NPC. It's used alone as part of chemoradiation. It may be combined with another drug, 5-fluorouracil (5-FU), if it's given after chemoradiation or radiation.

Some other drugs may also be helpful in treating NPC that has spread. These include:

  • Carboplatin (Paraplatin®)
  • Doxorubicin (Adriamycin®)
  • Epirubicin (Ellence®)
  • Paclitaxel (Taxol®)
  • Docetaxel (Taxotere®)
  • Gemcitabine (Gemzar®)
  • Bleomycin
  • Methotrexate

Often 2 or more of these drugs are used.

Possible side effects of chemotherapy

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body such as those in the bone marrow, the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemo, which can lead to certain side effects.

The side effects of chemo depend on the type and dose of drugs you're given and how long you get them. Common side effects include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea
  • Increased chance of infections (due to low white blood cell counts)
  • Easy bruising or bleeding (due to low blood platelet counts)
  • Fatigue (due to low red blood cell counts)

These side effects are usually short-term and go away over time after treatment ends. Once chemo starts, let your health care team know if you have side effects, so they can be treated. There are ways to prevent or treat many of the side effects of chemo. For example, many good drugs are available to help prevent or treat nausea and vomiting.

Certain drugs can have other side effects. For example, cisplatin can damage nerves (called neuropathy). This can sometimes lead to hearing loss or pain, burning, or tingling sensations; sensitivity to cold or heat; or weakness in the hands and feet. In most cases this gets better after treatment is stopped, but it may last a long time in some people. For more on nerve damage, see Peripheral Neuropathy Caused by Chemotherapy.

In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to keep side effects from getting worse.

More information about chemotherapy

For more general information about how chemotherapy is used to treat cancer, see Chemotherapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Chen YP, Tang LL, Yang Q, et al. Induction Chemotherapy plus Concurrent Chemoradiotherapy in Endemic Nasopharyngeal Carcinoma: Individual Patient Data Pooled Analysis of Four Randomized Trials. Clin Cancer Res. 2018;24(8):1824-1833.  

National Cancer Institute. Nasopharyngeal Cancer Treatment (Adult) (PDQ®)–Patient Version. March 1, 2018. Accessed at on April 23, 2018.

National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Head and Neck Cancers, Version I.2018 -- February 15, 2018. Accessed at on April 23, 2018.

Petkar I, Bhide S, Newbold K, Harrington K, Nutting C. Practice patterns for the radical treatment of nasopharyngeal cancer by head and neck oncologists in the United Kingdom. Br J Radiol. 2018 Feb 13:20170590.  

Last Revised: September 24, 2018

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