De-escalated Radiotherapy for Primary Tumor After Neoadjuvant Therapy With Toripalimab Plus Chemotherapy for Nasopharyngeal Carcinoma

What this Trial Is About

Researchers are studying patients with stage II-III nasopharyngeal carcinoma to evaluate whether reducing radiation doses after immunochemotherapy affects local tumor control and late radiation side effects. The study focuses on using neoadjuvant chemotherapy combined with immunotherapy to improve treatment responses and potentially allow lower radiation doses. This approach aims to balance tumor control with fewer long-term toxicities over a three-year period. Participants receive three cycles of induction therapy with gemcitabine, cisplatin, and Toripalimab. Those whose tumors shrink by over 75% and have no detectable Epstein-Barr virus DNA will receive a lower radiation dose of 60 Gy along with additional cycles of Toripalimab and cisplatin during radiotherapy. Others will undergo conventional radiation therapy at 70 Gy with concurrent cisplatin. If needed, extra radiation may be given to remaining tumor areas. Throughout the study, patients will be monitored with imaging and blood tests to assess tumor response and viral DNA levels. Researchers will track tumor control rates, survival, and radiation side effects up to three years after treatment. Participants will have regular clinical visits, laboratory tests, and assessments to evaluate both effectiveness and safety of the treatment approaches.

De-escalated Radiotherapy for Primary Tumor After Neoadjuvant Therapy With Toripalimab Plus Chemotherapy for Nasopharyngeal Carcinoma