***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM OF THE STUDY Previous results from our trial showed that adjuvant cisplatin and fluorouracil chemotherapy did not significantly improve survival after concurrent chemoradiotherapy ( CCRT ) in locoregionally advanced nasopharyngeal carcinoma ( NPC ) at 2 years . Here , we present the data of long-term survival and late toxicities to further assess the ultimate therapeutic index of adjuvant chemotherapy ( AC ) . METHODS Patients with stage III-IVB ( except T3 - 4N0 ) NPC were r and omly assigned to receive CCRT plus AC or CCRT only at seven institutions in China . Patients in both groups received cisplatin 40 mg/m2 weekly up to 7 weeks concurrently with radiotherapy . The CCRT plus AC group subsequently received adjuvant cisplatin 80 mg/m2 and fluorouracil 800 mg/m2/d for 120 h every 4 weeks for three cycles . The primary end-point was failure-free survival . RESULTS Two hundred and fifty-one patients were r and omised to the CCRT plus AC group and 257 to the CCRT only group . After a median follow-up of 68.4 months , estimated 5-year failure-free survival rate was 75 % in the CCRT plus AC group and 71 % in the CCRT only group ( hazard ratio 0.88 , 95 % confidence interval 0.64 - 1.22 ; p = 0.45 ) . 66 ( 27 % ) of 249 patients in the CCRT plus AC group and 53 ( 21 % ) of 254 patients in the CCRT only group developed one or more late grade 3 - 4 toxicities ( p = 0.14 ) . CONCLUSION Adjuvant cisplatin and fluorouracil chemotherapy still failed to demonstrate significant survival benefit after CCRT in locoregionally advanced NPC based on the long-term follow-up data , and addition of adjuvant cisplatin and fluorouracil did not significantly increase late toxicities . REGISTRATION NUMBER NCT00677118 BACKGROUND The value of adding cisplatin , fluorouracil , and docetaxel ( TPF ) induction chemotherapy to concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma is unclear . We aim ed to compare TPF induction chemotherapy plus concurrent chemoradiotherapy with concurrent chemoradiotherapy alone in a suitably powered trial . METHODS We did an open-label , phase 3 , multicentre , r and omised controlled trial at ten institutions in China . Patients with previously untreated , stage III-IVB ( except T3 - 4N0 ) nasopharyngeal carcinoma , aged 18 - 59 years without severe comorbidities were enrolled . Eligible patients were r and omly assigned ( 1:1 ) to receive induction chemotherapy plus concurrent chemoradiotherapy or concurrent chemoradiotherapy alone ( three cycles of 100 mg/m2 cisplatin every 3 weeks , concurrently with intensity-modulated radiotherapy ) . Induction chemotherapy was three cycles of intravenous docetaxel ( 60 mg/m2 on day 1 ) , intravenous cisplatin ( 60 mg/m2 on day 1 ) , and continuous intravenous fluorouracil ( 600 mg/m2 per day from day 1 to day 5 ) every 3 weeks before concurrent chemoradiotherapy . R and omisation was by a computer-generated r and om number code with a block size of four , stratified by treatment centre and disease stage ( III or IV ) . Treatment allocation was not masked . The primary endpoint was failure-free survival calculated from r and omisation to locoregional failure , distant failure , or death from any cause ; required sample size was 476 patients ( 238 per group ) . We did efficacy analyses in our intention-to-treat population . The follow-up is ongoing ; in this report , we present the 3-year survival results and acute toxic effects . This trial is registered with Clinical Trials.gov , number NCT01245959 . FINDINGS Between March 1 , 2011 , and Aug 22 , 2013 , 241 patients were assigned to induction chemotherapy plus concurrent chemoradiotherapy and 239 to concurrent chemoradiotherapy alone . After a median follow-up of 45 months ( IQR 38 - 49 ) , 3-year failure-free survival was 80 % ( 95 % CI 75 - 85 ) in the induction chemotherapy plus concurrent chemoradiotherapy group and 72 % ( 66 - 78 ) in the concurrent chemoradiotherapy alone group ( hazard ratio 0·68 , 95 % CI 0·48 - 0·97 ; p=0·034 ) . The most common grade 3 or 4 adverse events during treatment in the 239 patients in the induction chemotherapy plus concurrent chemoradiotherapy group versus the 238 patients in  concurrent chemoradiotherapy alone group were neutropenia ( 101 [ 42 % ] vs 17 [ 7 % ] ) , leucopenia ( 98 [ 41 % ] vs 41 [ 17 % ] ) , and stomatitis ( 98 [ 41 % ] vs 84 [ 35 % ] ) . INTERPRETATION Addition of TPF induction chemotherapy to concurrent chemoradiotherapy significantly improved failure-free survival in locoregionally advanced nasopharyngeal carcinoma with acceptable toxicity . Long-term follow-up is required to determine long-term efficacy and toxicities . FUNDING Shenzhen Main Luck Pharmaceuticals Inc , Sun Yat-sen University Clinical Research 5010 Program ( 2007037 ) , National Science and Technology Pillar Program during the Twelfth Five-year Plan Period ( 2014BAI09B10 ) , Health & Medical Collaborative Innovation Project of Guangzhou City ( 201400000001 ) , Planned Science and Technology Project of Guangdong Province ( 2013B020400004 ) , and The National Key Research and Development Program of China ( 2016YFC0902000 ) Background Concomitant chemotherapy (CT)-radiotherapy ( RT ) is a st and ard of care in locally advanced nasopharyngeal carcinoma ( NPC ) and a role for induction CT is not established . Methods Patients with locally advanced NPC , WHO type 2 or 3 , were r and omized to induction TPF plus concomitant cisplatin-RT or concomitant cisplatin-RT alone . The TPF regimen consisted of three cycles of Docetaxel 75 mg/m2 day 1 ; cisplatin 75 mg/m2 day 1 ; 5FU 750 mg/m2/day days 1 - 5 . RT consisted of 70 Gy in 7 weeks plus concomitant cisplatin 40 mg/m2 weekly . Results A total of 83 patients were included in the study . Demographics and tumour characteristics were well balanced between both arms . Most of the patients ( 95 % ) in the TPF arm received three cycles of induction CT . The rate of grade 3 - 4 toxicity and the compliance ( NCI-CTCAE v3 ) during cisplatin-RT were not different between both arms . With a median follow-up of 43.1 months , the 3-year PFS rate was 73.9 % in the TPF arm versus 57.2 % in the reference arm [ hazard ratio ( HR ) = 0.44 ; 95 % confidence interval ( CI ) : 0.20 - 0.97 , P = 0.042 ] . Similarly the 3 years overall survival rate was 86.3 % in the TPF arm versus 68.9 % in the reference arm ( HR = 0.40 ; 95 % CI : 0.15 - 1.04 , P = 0.05 ) . Conclusion In conclusion , several important aspects can be emphasized : the compliance to induction TPF was good and TPF did not compromise the tolerance of the concomitant RT-cisplatin phase . The improved PFS and overall survival rates needs to be confirmed by further trials Purpose : Because of the uneven geographic distribution and small number of r and omized trials available , the value of additional induction chemotherapy ( IC ) to concurrent chemoradiotherapy ( CCRT ) in nasopharyngeal carcinoma ( NPC ) remains controversial . This study performed an individual patient data ( IPD ) pooled analysis to better assess the precise role of IC + CCRT in locoregionally advanced NPC . Experimental Design : Four r and omized trials in endemic areas were identified , representing 1,193 patients ; up date d IPD were obtained . Progression-free survival ( PFS ) and overall survival ( OS ) were the primary and secondary endpoints , respectively . Results : Median follow-up was 5.0 years . The HR for PFS was 0.70 [ 95 % confidence interval ( CI ) , 0.56–0.86 ; P = 0.0009 ; 9.3 % absolute benefit at 5 years ] in favor of IC + CCRT versus CCRT alone . IC + CCRT also improved OS ( HR = 0.75 ; 95 % CI , 0.57–0.99 ; P = 0.04 ) and reduced distant failure ( HR = 0.68 ; 95 % CI , 0.51–0.90 ; P = 0.008 ) . IC + CCRT had a tendency to improve locoregional control compared with CCRT alone ( HR = 0.70 ; 95 % CI , 0.48–1.01 ; P = 0.06 ) . There was no heterogeneity between trials in any analysis . No interactions between patient characteristics and treatment effects on PFS or OS were found . After adding two supplementary trials to provide a more comprehensive overview , the conclusions remained valid and were strengthened . In a supplementary Bayesian network analysis , no statistically significant differences in survival between different IC regimens were detected . Conclusions : This IPD pooled analysis demonstrates the superiority of additional IC over CCRT alone in locoregionally advanced NPC , with the survival benefit mainly associated with improved distant control . Clin Cancer Res ; 24(8 ) ; 1824–33 . © 2018 AACR PURPOSE To investigate whether reducing the target volume of intensity-modulated radiotherapy ( IMRT ) after induction chemotherapy ( IC ) improves the quality of life ( QOL ) in locoregionally advanced nasopharyngeal carcinoma ( NPC ) without decreasing the local control and survival rate . PATIENTS AND METHODS A total number of 212 NPC patients staged as III-IVb were r and omly assigned to group A ( n=97 ) or group B ( n=115 ) in this prospect i ve clinical trial . All patients received IC followed by cisplatin concurrent with IMRT . IMRT was planned using the images of pre-IC in group A and post-IC in group B. RESULTS The dose received by normal tissues in group B was lower than that of group A ( P<0.05 ) . The recovery of the dry mouth symptoms in group B was significantly improved than group B. The quality of life ( QOL ) scores in group B were higher than group A. With a median follow-up of 35months , the 1-year estimated overall survival ( OS ) , progression-free survival ( PFS ) , locoregional failure-free survival ( LRFFS ) , distant metastasis-free survival ( DMFS ) in group A versus group B were 97.9 % vs 97.3 % , 90.7 % vs 92,2 % , 99.0 % vs 98.2 % , 91.8 % vs 94.8 % . The 2-year OS , PFS , LRFFS , DMFS in group A versus group B were 93.7 % vs 92.9 % , 83.4 % vs 84.3 % , 96.8 % vs 95.5 % , 86.5 % vs 89.5 % . The 3-year OS , PFS , LRFFS , DMFS in group A versus group B were 82.3 % vs 87 % , 74.7 % vs 83.4 % , 91.8 vs 93.9 % , 81.3 % vs 88.6 % , respectively . CONCLUSION Reducing the IMRT target volume after IC did not reduce the local control and survival rate in locoregionally advanced NPC but the doses received by normal tissues were decreased , and the QOL scores were improved PURPOSE To compare survival , tumor control , toxicities , and quality of life of patients with locally advanced nasopharyngeal carcinoma ( NPC ) treated with induction chemotherapy and concurrent chemo-radiation ( CCRT )  , against CCRT alone . PATIENTS AND METHODS Patients were stratified by N stage and r and omized to induction GCP ( 3 cycles of gemcitabine 1000 mg/m(2 ) , carboplatin area under the concentration-time-curve 2.5 , and paclitaxel 70 mg/m(2 ) given days 1 and 8 every 21 days ) followed by CCRT ( radiation therapy 69.96 Gy with weekly cisplatin 40 mg/m(2 ) ) , or CCRT alone . The accrual of 172 was planned to detect a 15 % difference in 5-year overall survival ( OS ) with a 5 % significance 
    Output:
    
Compared with CCRT , IC + CCRT showed higher relative risks of grade 3 or more neutropenia , thrombocytopenia , nausea , vomiting and hepatotoxicity throughout the course of treatment , and higher relative risks of grade ≥ 3 thrombocytopenia and vomiting during CCRT .
IC combined with CCRT significantly improved the survival in locoregional advanced NPC patients .
Moreover , toxicities were well tolerated during IC and CCRT .