Gemcitabine and Oxaliplatin (GEMOX) in First Line Metastatic or Recurrent Nasopharyngeal Carcinoma

Inclusion Criteria

• •Patients with histologically or cytologically proven nasopharyngeal carcinoma (NPC) with metastatic or recurrent disease that is not amenable to potentially curative surgery or radiotherapy. They must not have prior chemotherapy for the treatment of metastatic or recurrent disease.
• •Prior neoadjuvant, adjuvant or concurrent chemotherapy is allowed as long as a minimum period of 6 weeks has elapsed since the last day of treatment. This includes the use of carboplatin or cisplatin.
• •Patients must have at least one uni-dimensional measurable lesion (according to RECIST criteria)
• •Prior RT or surgery to the target lesion(s) is allowed as long as there is documented disease progression within the RT/ surgical field, and a minimum period of 6 weeks has elapsed since the last day of treatment.
• •Eastern Cooperative Oncology Group performance status of 0-2
• •No serious, uncontrolled medical conditions that may be aggravated by treatment.
• •No other malignancy(s), except completely excised basal or squamous cell carcinoma of the skin, or completely treated carcinoma-in-situ of the cervix.
• •Adequate hematological function:absolute granulocyte count \> 1.5 x 10\^9/L, platelet count \> 100 x 10\^9/L
• •Adequate renal and hepatic functions:·serum creatinine \< 1.25 x upper normal limit (UNL) or a calculated creatinine clearance \> 50 mL/min·serum bilirubin \< 2 x UNL and Aspartate aminotransferase/Alanine aminotransferase \< 3 x UNL