Efficacy of endoscopy in assessing the local disease response in nasopharyngeal carcinoma patients after treated with intensity-modulated radiotherapy.

Abstract

The optimal local disease assessment after intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) patients remains unclear. Our aim was to investigate the efficacy of post-IMRT endoscopies. The medical record of NPC patients with IMRT treatments during 2013 to 2015 was reviewed. Endoscopies and nasopharyngeal biopsies were performed at 6weeks post-IMRT. Second biopsies were performed 4weeks later for patients with abnormal first biopsies. Results of endoscopic assessments were correlated with histology using standard descriptive statistics. A total of 262 patients were reviewed. Endoscopy showed a sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of 71%, 90%, 41% and 97%, respectively. Disease remission at 6weeks was observed in 234 patients (89.3%). Sixteen patients (6.1%) had ultimate disease remission (late responders) and 12 (4.6%) had persistent local disease. Endoscopy had high specificity and NPV; therefore, invasive biopsy could be exempted in case of normal endoscopy.