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Clinical and Translational Oncology

, Volume 19, Issue 6, pp 777–783 | Cite as

Nasopharyngeal carcinoma: 30-year experience of a single institution in a non-endemic area

  • J. García-Lorenzo
  • N. Farre
  • A. Codina
  • O. Gallego
  • M. De Vega
  • X. León
Research Article

Abstract

Purpose

Over the past years, radiotherapy techniques have changed significantly. The impact of these changes in the management of nasopharyngeal carcinoma (NPC) has not been fully evaluated.

Methods/patients

Between 1984 and 2014, 223 NPC were diagnosed in our hospital. Prior to 2000, patients were treated with 2D treatment plan (RT2D) that evolved to 3D schemes thereafter (RT3D).

Results

Tumors in the RT3D period showed significantly lower stages than those in the RT2D period. 5-year cause-specific survival improved from 55.7% (95% CI: 46.7–64.7%) in the RT2D period to 78.7% (95% CI: 68.7–88.7%) in the RT3D period (P = 0.006). This difference was greater for non-keratinizing NPC, where specific survival went from 63.2% (95% CI: 52.2–74.2%) to 84.4% (95% CI: 74.4–94.4%) (P = 0.014).

Conclusion

Recent changes in treatment strategies including concurrent chemoradiation and 3D radiotherapy may have impacted in better survival for NPC. Improved imaging techniques may have contributed by earlier detection and better treatment planning.

Keywords

Nasopharyngeal carcinoma Radiation therapy IMRT Chemotherapy Chemoradiation 

Notes

Acknowledgements

This work was supported by a grant from the Instituto de Salud Carlos III (FIS PI14/01918). The study was cofunded by Fondo Europeo de Desarrollo Regional (FEDER), A Way to Build Europe.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The present work is a retrospective analysis of clinical data. For this type of study formal consent is not required.

References

  1. 1.
    Chan JKC, Pilch BZ, Kuo TT, Wening BM, Lee AW. Tumours of the nasopharynx. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and genetics of head and neck tumours. World Health Organization classification of tumours. Lyon: IARC Press; 2005.Google Scholar
  2. 2.
    Reddy SP, Raslan WF, Gooneratne S, Kathuria S, Marks JE. Prognostic significance of keratinization in nasopharyngeal carcinoma. Am J Otolaryngol. 1995;16(2):103–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Wei WI, Sham JS. Nasopharyngeal carcinoma. Lancet. 2005;365(9476):2041–54.CrossRefPubMedGoogle Scholar
  4. 4.
    Zong J, Lin S, Lin J, Tang L, Chen B, Zhang M, et al. Impact of intensity-modulated radiotherapy on nasopharyngeal carcinoma: Validation of the 7th edition AJCC staging system. Oral Oncol. 2015;51(3):254–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Xiao WW, Huang SM, Han F, Wu SX, Lu LX, Lin CG, et al. Local control, survival, and late toxicities of locally advanced nasopharyngeal carcinoma treated by simultaneous modulated accelerated radiotherapy combined with cisplatin concurrent chemotherapy: long-term results of a phase 2 study. Cancer. 2011;117(9):1874–83.CrossRefPubMedGoogle Scholar
  6. 6.
    OuYang PY, Xie C, Mao YP, Zhang Y, Liang XX, Su Z, et al. Significant efficacies of neoadjuvant and adjuvant chemotherapy for nasopharyngeal carcinoma by meta-analysis of published literature-based randomized, controlled trials. Ann Oncol. 2013;24(8):2136–46.CrossRefPubMedGoogle Scholar
  7. 7.
    Yi J, Huang X, Gao L, Luo J, Zhang S, Wang K, et al. Intensity-modulated radiotherapy with simultaneous integrated boost for locoregionally advanced nasopharyngeal carcinoma. Radiat Oncol. 2014;9:56.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Xu T, Zhu G, He X, Ying H, Hu C. A phase III randomized study comparing neoadjuvant chemotherapy with concurrent chemotherapy combined with radiotherapy for locoregionally advanced nasopharyngeal carcinoma: updated long-term survival outcomes. Oral Oncol. 2014;50(2):71–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Leon X, Orus C, Quer M. Design, maintenance, and exploitation of an oncologic database for patients with malignant tumors of the head and neck. Acta Otorrinolaringol Esp. 2002;53(3):185–90.CrossRefPubMedGoogle Scholar
  10. 10.
    Gregoire V, Coche E, Cosnard G, Hamoir M, Reychler H. Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. Proposal for standardizing terminology and procedure based on the surgical experience. Radiother Oncol. 2000;56(2):135–50.CrossRefPubMedGoogle Scholar
  11. 11.
    Gregoire V, Levendag P, Ang KK, Bernier J, Braaksma M, Budach V, et al. CT-based delineation of lymph node levels and related CTVs in the node-negative neck: DAHANCA, EORTC, GORTEC, NCIC, RTOG consensus guidelines. Radiother Oncol. 2003;69(3):227–36.CrossRefPubMedGoogle Scholar
  12. 12.
    ICRU 50. Dose specification for reporting external beam therapy with photons and electrons. International Commission on Radiation Units and Measurements, Washington, DC;1993. Report No: 50.Google Scholar
  13. 13.
    Hunt MA, Zelefsky MJ, Wolden S, Chui CS, LoSasso T, Rosenzweig K, et al. Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer. Int J Radiat Oncol Biol Phys. 2001;49(3):623–32.CrossRefPubMedGoogle Scholar
  14. 14.
    Lee N, Harris J, Garden AS, Straube W, Glisson B, Xia P, et al. Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase II trial 0225. J Clin Oncol. 2009;27(22):3684–90.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Bentzen SM, Constine LS, Deasy JO, Eisbruch A, Jackson A, Marks LB, et al. Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys. 2010;76(3 Suppl):S3–9.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 1998;16(4):1310–7.CrossRefPubMedGoogle Scholar
  17. 17.
    Jiong L, Berrino F, Coebergh JW. Variation in survival for adults with nasopharyngeal cancer in Europe, 1978-1989 EUROCARE Working Group. Eur J Cancer. 1998;34:2162–6 (14 Spec No).CrossRefPubMedGoogle Scholar
  18. 18.
    Arnold M, Wildeman MA, Visser O, Karim-Kos HE, Middeldorp JM, Fles R, et al. Lower mortality from nasopharyngeal cancer in The Netherlands since 1970 with differential incidence trends in histopathology. Oral Oncol. 2012;49(3):237–43.CrossRefPubMedGoogle Scholar
  19. 19.
    Zhang L, Zhao C, Ghimire B, Hong MH, Liu Q, Zhang Y, et al. The role of concurrent chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma among endemic population: a meta-analysis of the phase III randomized trials. BMC Cancer. 2010;10:558.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Anandan C, Elton R, Hitchings A, Brewster DH. Nasopharyngeal cancer incidence and survival in Scotland, 1975-2001. Clin Otolaryngol. 2008;33(1):12–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Chua ML, Wee JT, Hui EP, Chan AT. Nasopharyngeal carcinoma. Lancet. 2016;387(10022):1012–24.CrossRefPubMedGoogle Scholar
  22. 22.
    Blanchard P, Lee A, Marguet S, Leclercq J, Ng WT, Ma J, et al. Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis. Lancet Oncol. 2015;16(6):645–55.CrossRefPubMedGoogle Scholar
  23. 23.
    Boscolo-Rizzo P, Tirelli G, Mantovani M, Baggio V, Lupato V, Spinato G, et al. Non-endemic locoregionally advanced nasopharyngeal carcinoma: long-term outcome after induction plus concurrent chemoradiotherapy in everyday clinical practice. Eur Arch Otorhinolaryngol. 2014;272(11):3491–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Manavis J, Sivridis L, Koukourakis MI. Nasopharyngeal carcinoma: the impact of CT-scan and of MRI on staging, radiotherapy treatment planning, and outcome of the disease. Clin Imaging. 2005;29(2):128–33.PubMedGoogle Scholar
  25. 25.
    Ng SH, Chan SC, Yen TC, Liao CT, Chang JT, Ko SF, et al. Comprehensive imaging of residual/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT. Eur Radiol. 2010;20(9):2229–40.CrossRefPubMedGoogle Scholar
  26. 26.
    Liu T, Xu W, Yan WL, Ye M, Bai YR, Huang G. FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review. Radiother Oncol. 2007;85(3):327–35.CrossRefPubMedGoogle Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2017

Authors and Affiliations

  1. 1.Otorhinolaryngology DepartmentHospital de la Santa Creu I Sant PauBarcelonaSpain
  2. 2.Radiation Oncology DepartmentHospital de la Santa Creu I Sant PauBarcelonaSpain
  3. 3.Medical Oncology DepartmentHospital de la Santa Creu I Sant PauBarcelonaSpain

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