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Nasopharyngeal carcinoma

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Opinion statement

Nasopharyngeal carcinoma is usually present as locally advanced (stage III or IV) disease. Before 1980, the primary treatment was radiotherapy. The 5-year survival rate of patients with stage IVM0 across the world was less than 30%. Local, regional, and systemic recurrences are high in these patients and contributed to the poor survival. Sequential chemotherapy followed by radiotherapy (especially with the combination of cisplatin and 5-fluorouracil infusion for three courses) resulted in a 5-year survival rate of up to 55% in patients with stage IV disease. Concurrent single-agent cisplatin and radiotherapy improved 5-year survival rate to up to 55% in these patients. Total treatment with concurrent chemoradiotherapy followed by adjuvant cisplatin and 5-fluorouracil infusion resulted in 5-year survival rate of approximately 75%. Reversing the sequence of treatment by giving chemotherapy followed by concurrent chemoradiotherapy may improve the 5-year survival to up to 90%. In patients with recurrent disease or systemic metastases, the chances of salvage and long remission (many years) is approximately 15% to 20% with the use of adequate and effective chemotherapy. Newer agents, alone or concomitant with radiotherapy, are being evaluated in these patients.

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References and Recommended Reading

  1. Henle W, Henle A: Epstein-Barr virus specific IgA serum antibodies as an outstanding feature of nasopharyngeal carcinoma. Int J Cancer 1976, 17:1–7.

    Article  PubMed  CAS  Google Scholar 

  2. Levine PH, Pocinki AG, Madigan P, Bales S: Familial nasopharyngeal cancer in patients who are not Chinese. Cancer 1992, 70:1024–1029.

    Article  PubMed  CAS  Google Scholar 

  3. Fong YY, Walsh EO: Carcinogenic nitrosamines in Cantonese salt dried fish. Lancet 1971, 2:1032.

    Article  PubMed  CAS  Google Scholar 

  4. Fleming ID, Cooper JS, Henson DE, et al.: American Joint Committee on Cancer Staging Manual, edn 5. Philadelphia: Lippincott-Raven; 1997.

    Google Scholar 

  5. Yu ZH, Xu GZ, Huang YR, et al.: Value of computed tomography in staging the primary lesion of NPC: an analysis of 54 patients with special reference to the parapharyngeal space. Int J Radiat Oncol Biol Phys 1985, 11:2143–2147.

    PubMed  CAS  Google Scholar 

  6. Chong VF, Ian FF: Detection of recurrent nasopharyngeal carcinoma MRI versus CT. Radiology 1997, 202:463–470.

    PubMed  CAS  Google Scholar 

  7. Kutcher GJ, Zuks G, Brenner H, et al.: Threedimensional photon treatment planning for carcinoma of nasopharynx. Int J Radiat Biol Phys 1991, 21:169.

    CAS  Google Scholar 

  8. Sultanem K, Shu HK, Xia P, et al.: 3D intensity modulated radiotherapy in the treatment of nasopharyngeal carcinoma: the UCSF experience. Int J Radiat Oncol Biol Phys 1999, 45:151.

    Article  Google Scholar 

  9. Mesic JB, Fletcher GH, Goepfert H: Mega voltage irradiation of epithelial tumors of the nasopharynx. Int J Radiat Oncol Biol Phys 1981, 7:447–453.

    PubMed  CAS  Google Scholar 

  10. Qin D, Hu Y, Yan J, et al.: Analysis of 1379 patients with nasopharyngeal carcinoma treated by radiation. Cancer 1988, 61:1117–1124.

    Article  PubMed  CAS  Google Scholar 

  11. Wang DC, Cai WM, Hu VC, et al.: Long-term survival of 1035 cases of nasopharyngeal carcinoma. Cancer 1998, 61:2338–2341.

    Article  Google Scholar 

  12. Chang SD, Tate DJ, Goffinet DR, et al.: Treatment of nasopharyngeal carcinoma: stereotactic radiosurgical boost follow-up fractionation radiotherapy. Stereotact Funct Neurosurg 1999, 73:6467.

    Article  Google Scholar 

  13. Yan JH, Qin DX, Hu YH, et al.: Management of local residual primary lesion of NPC: are higher doses beneficial? Int J Radiat Oncol Biol Phys 1989, 16:1465–1469.

    PubMed  CAS  Google Scholar 

  14. Leibel SA, Kutcher GJ, Harrison LB, et al.: Improved dose distributions for 3D conformal boost treatments in carcinoma of the nasopharynx. Int J Radiat Oncol Biol Phys1991, 20:823–833.

    PubMed  CAS  Google Scholar 

  15. Wang CC: Reirradiation of recurrent nasopharyngeal carcinoma-treatment techniques and results. Int J Radiat Oncol Biol Phys 1987, 13:953–956.

    PubMed  CAS  Google Scholar 

  16. Harrison LB, Weissberg JB: A technique for interstitial nasopharyngeal brachytherapy. Int J Radiat Oncol Biol Phys 1987, 13:451–453.

    PubMed  CAS  Google Scholar 

  17. Pryzant RM, Wendt CD, Delclos L, Peters LJ: Retreatment of nasopharyngeal carcinoma in 53 patients. Int J Radiat Oncol Biol Phys 1992, 22:941–947.

    PubMed  CAS  Google Scholar 

  18. Decker DA, Drelichman A, Al-Sarraf M, et al.: Chemotherapy for nasopharyngeal cancer. A ten year experience. Cancer 1983, 52:602–605.

    Article  PubMed  CAS  Google Scholar 

  19. Al-Kourainy K, Crissman J, Ensley J, et al.: Excellent response to cisplatin based chemptherapy in patients with recurrent or previously untreated advanced nasopharyngeal carcinoma. Am J Clin Oncol 1988, 11:427–430.

    Article  PubMed  CAS  Google Scholar 

  20. Al-Sarraf M: Chemotherapeutic management of head and neck cancer. Cancer Metastasis Rev 1987, 6:181–198.

    Article  PubMed  CAS  Google Scholar 

  21. Al-Sarraf M: Head and Neck cancer: Chemotherapy concepts. Sem Oncol 1988, 15:70–85. This is a very important review of chemotherapy concepts in patients with head and neck cancers.

    CAS  Google Scholar 

  22. Ahmad A, Stefani S: Distant metastasis of nasopharyngeal carcinoma. A study of 256 male patients. J Surg Oncol 1986, 33:194–197.

    Article  PubMed  CAS  Google Scholar 

  23. Tan EH, Khoo KS, Wee J, et al.: Phase II trial of paclitaxel and carboplatin combination in Asian patients with metastatic nasopharyngeal carcinoma. Ann Oncol 1999, 10:235–237.

    Article  PubMed  CAS  Google Scholar 

  24. Stein MF, Ruff P, Weaving A, et al.: A Phase II study of cisplatin/ifosphamide in recurrent/metastatic undifferentiated nasopharyngeal carcinoma among young blacks in South Africa. Am J Clin Oncol 1996, 19:386–388.

    Article  PubMed  CAS  Google Scholar 

  25. Geara FB, Glisson BS, Sanguineti G, et al.: Induction chemotherapy followed by radiotherapy versus radiotherapy alone in patients with advanced nasopharyngeal carcinoma: results of a matched cohort study. Cancer 1997, 79:1279–1286. This is an important study of induction chemotherapy followed by radiotherapy and the improvement in all parameters of results, including overall survival.

    Article  PubMed  CAS  Google Scholar 

  26. Teo PM, Chan AT, Lee Wy, et al.: Enhancement of local control in locally advanced node-positive nasopharyngeal carcinoma by adjuvant chemotherapy. Int J Radiat Oncol Biol Phys 1999, 43:261–271.

    Article  PubMed  CAS  Google Scholar 

  27. Al-Sarraf M, Pajak TF, Cooper JF, et al.: Chemo-radiotherapy in patients with locally advanced nasopharyngeal carcinoma: a Radiation Therapy Oncology Group study. J Clin Oncol 1990, 8:1342–1351. This is an important study of concurrent cisplatin and radiotherapy and the influence on 5-year survival as compared with matched historical control.

    PubMed  CAS  Google Scholar 

  28. Chan ATC, Teo PML, Ngan RKC, et al.: A Phase III randomized trial comparing concurrent chemotherapy-radiotherapy with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. Proc Am Soc Clin Oncol 2000, 19:415a.

    Google Scholar 

  29. Rossi A, Molinari R, Boracchi P, et al.: Adjuvant chemotherapy with vincristine, cyclophosphamide, and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: results of a 4-year multicenter randomized study. J Clin Oncol 1998, 6:1401–1410.

    Google Scholar 

  30. Al-Sarraf M, LeBlanc M, Giri PG, et al.: Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: Phase III randomized Intergroup study 0099. J Clin Oncol 1998, 16:1310–1317. This is a very important Intergroup Phase III randomized and stratified trial in North America to show the superiority of chemoradiotherapy versus radiotherapy in nasopharyngeal cancer.

    PubMed  CAS  Google Scholar 

  31. Al-Sarraf M, LeBlanc M, Giri PG, et al.: Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer. Intergroup (0099) SWOG 8892, RTOG 8817, ECOG 2388, Progress report. Proc Am Soc Clin Oncol 1998, 17:385a.

    Google Scholar 

  32. Al-Sarraf M, LeBlanc M, Giri PG, et al.: Superiority of five-year survival with chemoradiotherapy versus radiotherapy in patients with locally advanced nasopharyngeal cancer. Intergroup (0099), SWOG 8892, RTOG 8817, ECOG 2388 Phase III study: final report. Proc Am Soc Clin Oncol 2001, 20:227a. This is an important update of the Intergroup Phase III trial with minimal follow-up of 5 years to show the continued improvement in overall survival.

    Google Scholar 

  33. Rischin D, Peters L, Smith J, et al.: A Phase II trial of epirubicin, cisplatin, and infusional 5-fluorouracil followed by radiotherapy and concurrent cisplatin in patients with locally advanced nasopharyngeal cancer. Proc Am Soc Clin Oncol 2001, 20:227a. This is an important study that shows continued improved results by changing the sequence of chemotherapy and chemoradiotherapy.

    Google Scholar 

  34. Ma J, Mai H-Q, Hong M-H, et al.: Results of a prospective randomized trial comparing neoadjuvant chemotherapy plus radiotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol 2001, 19:1350–1357.

    PubMed  CAS  Google Scholar 

  35. Wolden SL, Zelefsky MJ, Kraus DH, et al.: Accelerated concomitant boost radiotherapy and chemotherapy for advanced nasopharyngeal carcinoma. J Clin Oncol 2001, 19:1105–1110.

    PubMed  CAS  Google Scholar 

  36. Chau DTT, Sham JST, Choy D, et al.: Preliminary report of the Asian-Oceanian clinical oncology association randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. Cancer 1998, 83:2270–2283.

    Article  Google Scholar 

  37. Cvitkovic E, Grange GRL, Temple S, et al.: Neoadjuvant chemotherapy (NACT) with epirubicin (EPI), cisplatin (CDDP), bleomycin (BLEO) in undifferentiated nasopharyngeal cancer (UCNT): preliminary results of an international phase III trial. Proc Am Soc Clin Oncol 1994, 13:283.

    Google Scholar 

  38. International Nasopharyngeal Cancer Study Group: Preliminary results of the randomized trial comparing neoadjuvant chemotherapy (cisplatinum, epirubicin, bleomycin) plus radiotherapy versus radiotherapy alone in stage IV (>N2. M0) undifferentiated nasopharyngeal cancer. Int J Radiat Oncol Biol Phys 1996, 35:463–469.

    Article  Google Scholar 

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Authors and Affiliations

  1. Rose Cancer Center, William Beaumont Hospital, 3577 West 13 Mile Road, Suite 404, 48073, Royal Oak, MI, USA

    Muhyi Al- Sarraf MD, FRCPC, FACP & Maryada S. Reddy MD

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  1. Muhyi Al- Sarraf MD, FRCPC, FACP
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  2. Maryada S. Reddy MD
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Sarraf, M.A., Reddy, M.S. Nasopharyngeal carcinoma. Curr. Treat. Options in Oncol. 3, 21–32 (2002). https://doi.org/10.1007/s11864-002-0038-8

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  • DOI: https://doi.org/10.1007/s11864-002-0038-8

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