The role of MRI in staging and radiotherapy treatment planning in locally advanced nasopharyngeal carcinoma – case report

Abstract

Nasopharyngeal carcinoma (NPC) is a rare disease. The “Golden imaging standard” for primary tumor and regional lymph nodes staging in NPC is MRI- magnetic resonance imaging. Radiotherapy is the main treatment modality in both early and locoregional advanced NPC. Radiotherapy alone is recommended only in T1N0M0 stage NPC, while in higher stages for best treatment results contributes radiotherapy with concomitant chemotherapy. The aim is to report a case of a patients with NPC presented to our department with clinical and MRI data for scull base and brain invasion. Tumor staging included PET/CT scan and MRI, which were used also for treatment planning. The patient was treated with definitive radiotherapy to 64 Gy, concomitantly with weekly Cisplatin. VMAT and IGRT treatment techniques were used. One year later a complete response is observed without late toxicity and grade 2 dry mouth. Using of MRI for initial staging and radiotherapy planning in NPC is very important due to precise findings of the tumor invasion and a correct definition of the treatment volume. MRI staging should be part of the initial staging and follow up algorithm in all patients with NPC.