Clinical Study on Photodynamic Therapy (PDT) In Patients with Nasopharyngeal Carcinoma in Yogyakarta Review of Life Expectancy and Cytokine Level

Abstract

Background: Nasopharyngeal carcinoma is a malignancy in nasopharynx cavity originated from mucosal epithelial cell of nasopharynx. In Indonesia, nasopharyngeal carcinoma is the most considerable malignancy in head and neck area with the highest mortality rate. Objective: To perceive that photodynamic therapy in nasopharyngeal carcinoma either residual or recurrence patients after receiving radiation or in chemo radiation therapy will yield a well-responded therapy, better life expectancy compared to those who didn't receive PDT, and inducing systemic anti-tumor response which was marked by the increased level of immune-response cytokines. Methods: This research took place in Department of Otorhinolaryngology Head and Neck Surgery Faculty of Medicine University of Gadjah Mada/Dr Sardjito General Hospital Yogyakarta, Indonesia using cohort retrospective design. The subjects of this research are patients with residual or recurrence nasopharyngeal carcinoma who had received photodynamic therapies between the years 2005-2011. Pre and posttest examination were used to test the hypothesis of the cytokines level difference before and after photodynamic therapies. Results: As much as 58.1% patients were men, and 41.9% of patients were female. Most of the patients were above 40 years of age. As much as 21 out of 31 patients (67.7%) were previously diagnosed as nasopharyngeal carcinomas in late stages, in this case the given treatment was chemo radiation. The 5 years life expectancy of residual or recurrence nasopharyngeal carcinoma is 60.7%. This number was preferable compared to the life expectancy of nasopharyngeal carcinoma patients who received standard therapy of either radiation or chemo radiation. Residual and recurrence nasopharyngeal carcinoma patients diagnosed between year 2009- 2013 without photodynamic therapy showed the 5 year overall survival rate as much as 22.9% with the median 23.6 months. There was a significant difference of life expectancy either clinically or statistically in patients with residual of recurrence nasopharyngeal cancer who received PDT compared to those who did not (p=0.004). Conclusion: In long-term observation, it was reported that photodynamic therapy (PDT) increased the 5 years survival rate in patients with residual or recurrence nasopharyngeal carcinoma. Patients who received PDT had life expectancy 5 years longer than patients who did not receive PDT.