Abstract
PurposeIn Yogyakarta, nasopharyngeal carcinoma (NPC) shows a poor response to radiotherapy treatment. Previous study showed a prolonged overall treatment time (OTT), due to interruptions during treatment. This study explores the association between clinical outcome and OTT. Secondary, the relation between clinical outcome and disease stage, waiting time to radiation (WT) and chemotherapy schedule was explored.MethodsIn this retrospective cohort, 142 patients who started curative intent radiotherapy for NPC between March 2009 and May 2014, with or without chemotherapy, were included. The median follow up time was 1.9 years. Data was collected on WT, OTT, disease stage, and chemotherapy schedule. Time factors were log-transformed. Clinical outcome was defined as therapy response, loco-regional control (LRC), disease free survival (DFS) and overall survival (OS).ResultsThe median WT was 117 days (range 12–581) and OTT was 58 days (43–142). OTT and disease stage were not associated to any of the clinical outcome parameters. The log- WT was associated to poor therapy outcome (HR 1.68; 95% ci: 1.09–2.61), LRC (HR 1.66; 95% ci: 1.15–2.39), and DFS (HR 1.4; 95% ci: 1.09–1.81). In the multivariable analysis, significant hazard risk for poor therapy response, LRC, DFS and OS were seen for patients who didn’t received concurrent chemotherapy.ConclusionNot receiving concurrent chemotherapy showed the strongest risk for poor outcome. Since the choice of chemotherapy is related to a variety of factors, like the WT and patient’s physical condition when radiation can start, careful interpretation is needed. Reason for not finding a relation between OTT and clinical outcome might be the low number of patients who finished radiotherapy within 7 weeks, or by a stronger detrimental effect of other factors.
Highlights
Nasopharyngeal cancer (NPC) is the most common malignancy in the head and neck region in Indonesia [1]
Significant hazard risk for poor therapy response, loco-regional control (LRC), disease free survival (DFS) and overall survival (OS) were seen for patients who didn’t received concurrent chemotherapy
Not receiving concurrent chemotherapy showed the strongest risk for poor outcome
Summary
Nasopharyngeal cancer (NPC) is the most common malignancy in the head and neck region in Indonesia [1]. The incidence is estimated at 6:100 000, which is probably an underestimation since many patients living in the rural areas might stay undiagnosed [2]. 3- year overall survival for NPC are reported as 70 to 80%, or even higher. Studies in Indonesia showed a 3-year overall survival of only 30% [3, 4]. Most of the studies with the high survival rates are derived from clinics with advanced and readily available treatment facilities. More than 85% of the NPC patients are diagnosed in low- and middle-income countries, with less advanced equipment and limited capacity [2, 5]. Actual NPC survival will be much lower than reported in literature and more likely to be in the range of Yogyakarta. This study aims to identify factors associated with poor clinical outcome
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
