Abstract
Aim of Work: The aim of this work was to study the clinico-epidemiological characteristics of the patients with nasopharyngeal carcinoma (NPC), analyse the prognostic factors of the disease and to analyse the results of different treatment modalities and their effect on loco-regional, distal metastatic disease control and both overall survival (OS) and disease free survival (DFS) rates. Patients and Methods: This is a retrospective study reviewing all adult nasopharyngeal carcinoma (NPC) patients who presented to the radiotherapy department—National Cancer Institute Cairo University in the period from (2000-2010). Results: In this study, it was found that the mean age was 45 years; most of the patients were of locally advanced stages. Multivariate cox proportional hazards regression identified T-stage, radiotherapy course completion & addition of chemotherapy as independent prognostic factors for local control (LC), DFS, & OS. The 5-year LC, DFS and OS rates for all studied patients were 38.2%, 33.5% & 37.2% respectively. The median DFS was 26 months and median OS was 36.5 months. Conclusion: This study matches the published data that support that radical concurrent chemoradiation is the mainstay of treatment of locally advanced NPC, & that T-stage, M-stage, prescribed dose completion, response to initial treatment are independent prognostic factors for survival. All measures should be taken to improve the local response during primary treatment as this will improve survival rates of patients with NPC.
Highlights
Worldwide, there are 80,000 incident cases of nasopharyngeal carcinoma and 50,000 deaths annually [1]
Out of the 149 patients who received radical radiotherapy, twenty three patients (15.4%) were treated using 3D conformal radiotherapy (3D CRT) technique, while 2D technique was used for 121patients (81.2%) (Table 3)
Results of the current study demonstrated that, as the disease stage increased, the 5-year overall survival (OS) rates significantly decreased (p = 0.01) on univariate analysis, the clinical stage didn’t prove to be an independent prognostic factor of OS on multivariate analysis
Summary
There are 80,000 incident cases of nasopharyngeal carcinoma and 50,000 deaths annually [1]. The distinctive racial/ethnic and geographic distribution of NPC worldwide suggests that both environmental factors and genetic traits contribute to its development [2]. These unique pathogenic factors are variable such as genetic susceptibility, Epstein-Barr virus (EBV) infection, chemical carcinogens, and environmental factors [3]. Nasopharyngeal carcinoma (NPC) commonly demonstrates extensive invasion of adjacent tissues with poorly defined and large tumors in close proximity to critical structures, such as the brain stem, spinal cord, and optic chiasm. These features of NPC can complicate adequate surgical resection [5]
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