Results of treatment of patients with nasopharyngeal cancer after superselective chemoembolization of tumor vessels

Abstract

Background. Radiation therapy for locally advanced nasopharyngeal carcinoma (NC) has a high incidence of fatal complications, which leads to absolute contraindications to External Beam Radiation Therapy (EBRT). Chemoembolization of a nasopharyngeal tumor significantly reduces these risks and allows for EBRT. The aim of this study was to assess response rate after chemoembolization and EBRT. Objective. To evaluate the response rate in patients with locally advanced nasopharyngeal cancer treated with chemoembolization of tumor vessels and external beam radiation therapy in combination with chemotherapy. Methods. Prospective descriptive study was conducted. Patients with cT3–4, N0–2, M0 NC treated in April 2016 – March 2021 were enrolled. All patients had chemoembolization with doxorubicin’s microspheres followed by EBRT administrated once daily (2,0 Gy per fraction). Treatment response rate was assessed according RECIST 1.1 criteria in three weeks. Results. Twenty-one patients were identified. The median age was 47 years (IQR: 20–60). Tumors were staged as cT3N0M0 in 1 (4.8%) case, cT3N1M0 in 6 (28.6%) cases, cT3N2M0 in 5 (23.8%) cases, cT4N0M0 in 1 (4.8%) case, cT4N1M0 in 1 (4.8%) case and cT4N2M0 in 7 (33.4%) cases. There were the following histopathology types of NC: WHO type I (n = 1), WHO type II (n = 7) and WHO type III (n = 13). Fourteen (66.7%) patients had EBV-non-associated tumor and 7 patients were EBV-associated. Twenty (95.2%) patients had absolute contraindications to EBRT. All patients had chemoembolization. Complete response (CR) after chemoembolization was achieved in 3 (14.3%) patients, partial response (PR) was in 4 (19%) patients, stabilization was in 12 (57.1%), and progression was in 2 (9.6%) patients. All 21 patients had EBRT (median total dose 66 Gy [IQR: 60–72]).CR after EBRT was achieved in 17 (80%) patients and progression was in 4 (20%) patients. Conclusions. Chemoembolization provides acceptable response rate in patients with locally advanced NC and allows for EBRT. Further studies are needed to evaluate local control.