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Ergebnisse beim Nasopharynxkarzinom im Erwachsenenalter

Treatment results of nasopharyngeal carcinoma in adults

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Zusammenfassung

Hintergrund

Im Gegensatz zur endemischen Verbreitung in Asien oder Afrika ist das Nasopharynxkarzinom (NPC) in Deutschland eine seltene Tumorentität. In der vorliegenden Studie wurden retrospektiv die Patientencharakteristika und prognostischen Faktoren in Abhängigkeit von der Behandlung beim NPC untersucht.

Material und Methoden

Das Patientenkollektiv umfasst 63 Patienten mit NPC, die im Zeitraum 1990–2009 am Universitätsklinikum Bonn behandelt wurden.

Ergebnisse

Das mittlere Alter war 56,4 Jahre, das Verhältnis Männer zu Frauen betrug 3,2:1, ein Tumorstadium I/II nach Union Internationale Contre le Cancer (UICC) lag bei 23,8% und ein Stadium III/IV bei 76,2% der Fälle vor. Histologisch lag ein Typ I nach World Health Organization (WHO) in 9,6%, Typ II in 33,3% und Typ III in 57,1% der Fälle vor. Die 5-Jahres-Überlebensrate nach Radiochemotherapie (RCT) betrug 75% und nach Bestrahlungstherapie (RT) 60%. Die Sterberate vervielfachte sich um den Faktor 3,5 im nächst höheren Tumorstadium (p ≤ 0,047). Die Rezidivquote (RQ) unter RCT lag bei 34% und unter RT bei 68% (p ≤ 0,04) nach 5 Jahren. Eine Tumorablation steigerte die RQ signifikant (p ≤ 0,047).

Schlussfolgerung

Die RCT ist äußerst effektiv und der alleinigen RT bei der Behandlung des NPC überlegen. Die Tumorablation vor RCT/RT ist obsolet und verschlechtert die Prognose signifikant.

Abstract

Background

Nasopharyngeal carcinoma (NPC) is a rare tumor entity in Germany in contrast to endemic countries in Asia or Africa. This retrospective study investigated patient characteristics and prognostic factors with respect to different NPC treatment strategies.

Patients and methods

A total of 63 NPC patients treated during the period 1990–2009 at the University Hospital Bonn, Germany, were included.

Results

The median age of the patients was 56.4 years, the male:female ratio was 3.2:1, 23.8% were in Union Internationale Contre le Cancer (UICC) stage I/II and 76.2% were in stage III/IV. Most of the carcinomas were WHO type III (57.1%), followed by World Health Organization (WHO) type II (33.3%) and at last WHO type I (9.6%). The 5-year overall survival rate after concomitant chemoradiotherapy (RCT) was 75% and after radiotherapy (RT) 60%. The mortality rate increased by 3.5 times with each increase in T-stage (p ≤ 0.047). The recurrence rate (RR) after RCT was 34% and after RT alone 68% (p ≤ 0.04). Tumor ablation increased the RR significantly (p ≤ 0.047).

Conclusion

Combined chemotherapy and RT is an effective treatment of NPC disease and clearly superior to RT alone. Tumor ablation before RCT/RT worsens the prognosis and is now obsolete.

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Authors and Affiliations

  1. Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde/Chirurgie, Uniklinik Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland

    M. Jakob, M. Manz, S. Herberhold, A. Schröck, A.O.H. Gerstner & K. W. G. Eichhorn

  2. Klinik für Radiologie und Strahlentherapie, Uniklinik Bonn, Bonn, Deutschland

    H. Schüller

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  1. M. Jakob
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  2. M. Manz
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  3. S. Herberhold
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  5. A.O.H. Gerstner
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Correspondence to M. Jakob.

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Dieser Beitrag ist Herrn Prof. Dr. Dr. h.c. F. Bootz zum 60. Geburtstag gewidmet.

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Jakob, M., Manz, M., Herberhold, S. et al. Ergebnisse beim Nasopharynxkarzinom im Erwachsenenalter. HNO 60, 1075–1081 (2012). https://doi.org/10.1007/s00106-012-2633-8

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  • DOI: https://doi.org/10.1007/s00106-012-2633-8

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