Abstract
Nasopharynx cancers are classified differently from other types of head and neck cancers by their extensive lymphatic spread and frequent distant metastasis. In most cases RT is the only treatment modality because of the localization. Neoadjuvant chemotherapy studies are held to have better results in the local-regional advanced disease. 39 was treated in our clinic between August 91–June 94. Thirty of the 39 cases were treated according to the NF cancer treatment protocol of Dokuz Eylül University Head and Neck Cancer Group. Our treatment protocol for Stage I–III disease is curative RT and for Stage IV disease both neoadjuvant CT (CDDP + Bleomycin + Methotrexate) and RT. This protocol is activated in October 1992. Twenty-six cases were Stage IV, 3 cases Stage III, 1 case Stage II. Fifteen cases were treated by RT and CT and 15 cases were treated with RT alone. The applied RT technique and total doses are standard in all cases. Each case is irradiated with 50 Gy to the supraclavicular and cervical areas without lymphatic involvement and with 70 Gy irradiation to the primary tumor and to involved cervical lymph node areas. Neoadjuvant CT is applied two courses every 21 days and after and after subsequent tumor response evaluation, RT was started. Median follow-up period is 22 month (3–40 months). Three cases with distant metastases died. Local recurrence is detected in two cases and second series of RT was applied. A case with regional recurrence was treated with CT alone. Two cases were lost in follow up (one having a pulmonary metastasis). The rest of the patients are disease free.
Published Version
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