Retrospective analysis of treatment results for nasopharyngeal carcinoma in Philippine Oncology Centre Corporation from 2002-2009

Abstract

Objective: This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in Philippine Oncology Centre Corporation (POCC). Materials and Methods: The patients with NPC referred for treatment at POCC from 2002-2009 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), loco-regional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 106 patients with newly diagnosed NPC were treated in POCC during this period. Late presentation was common, with 19.8% presenting with T3-4 disease, 88.7% with N1-3 disease and 73.5% with AJCC stage 3-4 disease. Radical RT was given to 96 patients with 23.6% having RT alone and 67.4% having CCRT. The stipulated OTT was 7 weeks and 72% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 13.5% while adjuvant chemotherapy was administered to 17%. The 5 years OS was 51.5% with a median follow up of 56 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.9%, respectively. RT related late effects were documented in 71.7%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (18.2%), visual deficit (4.2%), neck stiffness (4.2%), dysphagia (2.3%), cranial nerve palsy (2.4%), pneumonitis (0.9%) and hypothyroidism (1.3%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.