Abstract
-
Nasopharyngeal carcinoma (NPC) is a relatively rare malignancy in Western countries, but it is the most commonly diagnosed head and neck cancer in Southeast Asia.
-
Early-stage NPC usually has no specific symptoms. Common signs and symptoms in advanced disease include cervical lymphadenopathy, nasal blockage, a nasal twang, and symptoms associated with distant metastasis such as bone pain.
-
Accuracy of clinical diagnosis is based on history and physical examination, laboratory, and imaging studies. Tissue from either primary or cervical lymphadenopathies can be used for pathologic diagnosis.
-
Stage at diagnosis is the most important prognostic factor. Long-term overall survival (OS) of patients with stages I–II disease exceeds 80% after conventional radiation, and those of stage III–IVB diseases ~60% after combined chemoradiation therapy. However, cure is unlikely once distant metastasis occurs.
-
Commonly observed metastatic sites include lung, bone, and liver. Although direct intracranial extension is common in the late stages, hematogenous metastasis to the brain or other organs/tissues is uncommon.
-
Treatment of NPC depends on the stage of the disease. Radiation therapy is the only curative treatment modality. Radiation alone for stages I and II NPC, and combined chemoradiotherapy for stages IIB–IVB diseases is the current standard.
-
As compared with conventional radiation therapy, intensity-modulated radiation therapy (IMRT) significantly improves therapeutic ratio and is the standard treatment technique for NPC currently.
-
Three-year overall survival, disease-free survival, and local control rates after IMRT or chemo-IMRT approximate 90, 85, and 95%, respectively, for non-metastatic NPC. Treatment-induced grades III or IV adverse effects are rare after IMRT.
-
Surgery is the mainstay treatment for recurrence in the neck, and local recurrent foci can be treated with nasopharyngectomy (selected cases) or irradiation.
-
Chemotherapy combined with palliative radiation therapy is the mainstay treatment for metastatic or recurrent NPC not suitable for definitive treatment.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Lu, J., Kong, L., Lee, N. (2011). Nasopharyngeal Carcinoma. In: Lu, J., Brady, L. (eds) Decision Making in Radiation Oncology. Medical Radiology(), vol 0. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-13832-4_3
Download citation
DOI: https://doi.org/10.1007/978-3-642-13832-4_3
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-12462-4
Online ISBN: 978-3-642-13832-4
eBook Packages: MedicineMedicine (R0)