Share This Article:

A Retrospective Study of Clinicoepidemiological Aspects of Nasopharyngeal Cancer at NCI-Cairo (2000-2010)

Abstract Full-Text HTML XML Download Download as PDF (Size:919KB) PP. 971-980
DOI: 10.4236/jct.2015.611105    2,623 Downloads   2,946 Views   Citations

ABSTRACT

Aim of Work: The aim of this work was to study the clinico-epidemiological characteristics of the patients with nasopharyngeal carcinoma (NPC), analyse the prognostic factors of the disease and to analyse the results of different treatment modalities and their effect on loco-regional, distal metastatic disease control and both overall survival (OS) and disease free survival (DFS) rates. Patients and Methods: This is a retrospective study reviewing all adult nasopharyngeal carcinoma (NPC) patients who presented to the radiotherapy department—National Cancer Institute Cairo University in the period from (2000-2010). Results: In this study, it was found that the mean age was 45 years; most of the patients were of locally advanced stages. Multivariate cox proportional hazards regression identified T-stage, radiotherapy course completion & addition of chemotherapy as independent prognostic factors for local control (LC), DFS, & OS. The 5-year LC, DFS and OS rates for all studied patients were 38.2%, 33.5% & 37.2% respectively. The median DFS was 26 months and median OS was 36.5 months. Conclusion: This study matches the published data that support that radical concurrent chemoradiation is the mainstay of treatment of locally advanced NPC, & that T-stage, M-stage, prescribed dose completion, response to initial treatment are independent prognostic factors for survival. All measures should be taken to improve the local response during primary treatment as this will improve survival rates of patients with NPC.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Ibrahim, H. , Shouman, T. , Taher, A. , Nasr, A. and Atef, H. (2015) A Retrospective Study of Clinicoepidemiological Aspects of Nasopharyngeal Cancer at NCI-Cairo (2000-2010). Journal of Cancer Therapy, 6, 971-980. doi: 10.4236/jct.2015.611105.

References

[1] Ferlay, J., Shin, H., Bray, F., et al. (2010) GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 10. International Agency for Research on Cancer, Lyon.
[2] Chang, E.T. and Adami, H.-O. (2006) The Enigmatic Epidemiology of Nasopharyngeal Carcinoma. Cancer Epidemiology, Biomarkers & Prevention, 15, 1765-1777.
http://dx.doi.org/10.1158/1055-9965.EPI-06-0353
[3] Cao, S.M., Simons, M.J. and Qian, C.N. (2011) The Prevalence and Prevention of Nasopharyngeal Carcinoma in China. Chinese Journal of Cancer, 30, 114-119.
http://dx.doi.org/10.5732/cjc.010.10377
[4] Edge, S.B. and Compton, C.C. (2010) American Joint Committee on Cancer: The 7th Edition of the AJCC Cancer Staging Manual and the Future of TNM. Annals of Surgical Oncology, 17, 1471-1474
[5] Wang, R.Z., Tan, Y., Wang, X.Y., Ma, L.L., Wang, D.M., Hu, Y.H. and Qin, Y.H. (2014) Prognoses and Long-Term Outcomes of Nasopharyngeal Carcinoma in Han and Uyghur Patients Treated with Intensity-Modulated Radiotherapy in the Xinjiang Autonomous Region of China. PLoS ONE, 9, e111145.
http://dx.doi.org/10.1371/journal.pone.0111145
[6] Zhang, L., Chen, Q.Y., Liu, H., et al. (2013) Emerging Treatment Options for Nasopharyngeal Carcinoma. Drug Design, Development and Therapy, 7, 37-52.
[7] Spratt, D.E. and Lee, N. (2012) Current and Emerging Treatment Options for Nasopharyngeal Carcinoma. OncoTargets and Therapy, 5, 297-308.
[8] Zheng, Y., Han, F., Xiao, W., et al. (2015) Analysis of Late Toxicity in Nasopharyngeal Carcinoma Patients Treated with Intensity Modulated Radiation Therapy. Radiation Oncology, 10, 17.
http://dx.doi.org/10.1186/s13014-014-0326-z
[9] Dawson, B. and Trapp, R.G., Eds. (2004) Basic and Clinical Biostatistics. 4th Edition, McGraw-Hill Professional.
[10] Oken, M.M., Creech, R.H., Tormey, D.C., et al. (1982) Toxicity and Response Criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5, 649-655.
http://dx.doi.org/10.1097/00000421-198212000-00014
[11] Ee Phua, V.C., Loo, W.H., Yusof, M.M., Ishak, W.Z.W., Tho, L.M. and Ung, N.M. (2013) Treatment Outcome for Nasopharyngeal Carcinoma in University Malaya Medical Centre from 2004-2008. Asian Pacific Journal of Cancer Prevention, 14, 4567-4570.
http://dx.doi.org/10.7314/APJCP.2013.14.8.4567
[12] Siti-Azrin, A.H., Norsa’adah, B. and Naing, N.N. (2014) Five-Year Survival and Median Survival Time of Nasopharyngeal Carcinoma in Hospital Universiti Sains Malaysia. Asian Pacific Journal of Cancer Prevention, 15, 6455-6459.
http://dx.doi.org/10.7314/APJCP.2014.15.15.6455
[13] Skinner, D.W., Van Hasselt, C.A. and Tsao, S.Y. (1991) Nasopharyngeal Carcinoma: Modes of Presentation. Annals of Otology, Rhinology & Laryngology, 100, 544-551.
http://dx.doi.org/10.1177/000348949110000705
[14] Sharma, T.D., Singh, T.T., Laishram, R.S., Sharma, L.D., Sunita, A.K. and Imchen, L.T. (2011) Nasopharyngeal Carcinoma—A Clinico-Pathological Study in a Regional Cancer Centre of Northeastern India. Asian Pacific Journal of Cancer Prevention, 12, 1583-1587.
[15] Lee, N., Xia, P., Quivey, J.M., Sultanem, K., Poon, I., Akazawa, C., et al. (2002) Intensity-Modulated Radiotherapy in the Treatment of Nasopharyngeal Carcinoma: An Update of the UCSF Experience. International Journal of Radiation Oncology, Biology, Physics, 53, 12-22.
http://dx.doi.org/10.1016/S0360-3016(02)02724-4
[16] Jang-Chun, L., Jing-Min, H. and Yee-Min, J., et al. (2014) Comparisons of Quality of Life for Patients with Nasopharyngeal Carcinoma after Treatment with Different RT Technologies. ACTA Otorhinolaryngologica Italic, 34, 241-246.
[17] Lee, A.W., Sze, W.M., Au, J.S., Leung, S.F., Leung, T.W., Chua, D.T.T., et al. (2005) Treatment Results from Nasopharyngeal Carcinoma in the Modern Era: The Hong Kong Experience. International Journal of Radiation Oncology, Biology, Physics, 61, 1107-1116.
http://dx.doi.org/10.1016/j.ijrobp.2004.07.702
[18] Yeh, S.A., Tang, Y., Lui, C.C., Huang, Y.-J. and Huang, E.-Y. (2005) Treatment Outcomes and Late Complications of 849 Patients with Nasopharyngeal Carcinoma Treated with Radiotherapy Alone. International Journal of Radiation Oncology, Biology, Physics, 62, 672-679.
http://dx.doi.org/10.1016/j.ijrobp.2004.11.002
[19] Sze, H.C., Ng, W.T., Chan, O.S., Shum, T.C.Y., Chan, L.L.K. and Lee, A.W.M. (2012) Radical Radiotherapy for Nasopharyngeal Carcinoma in Elderly Patients: The Importance of Co-Morbidity Assessment. Oral Oncology, 48, 162-167.
http://dx.doi.org/10.1016/j.oraloncology.2011.08.019
[20] Dou, H.Q., Hu, D.Y., Lam, C., Liu, Y.S., Wang, X.W. and Zhang, W.D. (2014) Retrospective Analysis of Results of Treatment for Nasopharyngeal Carcinoma in Macao. Chinese Journal of Cancer Research, 26, 148-158.
[21] Lai, S.Z., Li, W.F., Chen, L., Luo, W., Chen, Y.-Y., Liu, L.-Z., et al. (2011) How Does Intensity-Modulated Radiotherapy versus Conventional Two-Dimensional Radiotherapy Influence the Treatment Results in Nasopharyngeal Carcinoma Patients? International Journal of Radiation Oncology, Biology, Physics, 80, 661-668.
http://dx.doi.org/10.1016/j.ijrobp.2010.03.024
[22] Phua, C.E., Tan, B.S., Yong, T.K. and Govindasamy, M. (2011) Retrospective Analysis of Results of Treatment for Nasopharyngeal Carcinoma in Penang General Hospital from 2001-2005. Asian Pacific Journal of Cancer Prevention, 12, 3197-3200.
[23] Xiao, G.L., Cao, Y.B., Qiu, X.B., Wang, W.H. and Wang, Y.F. (2013) Influence of Gender and Age on the Survival of Patients with Nasopharyngeal Carcinoma. BMC Cancer, 13, 226.
http://dx.doi.org/10.1186/1471-2407-13-226
[24] Yi, J.L., Gao, L., Huang, X.D., Li, S.-Y., Luo, J.-W., Cai, W.-M., et al. (2006) Nasopharyngeal Carcinoma Treated by Radical Radiotherapy Alone: Ten-Year Experience of a Single Institution. International Journal of Radiation Oncology, Biology, Physics, 65, 161-168.
http://dx.doi.org/10.1016/j.ijrobp.2005.12.003
[25] Kawashima, M., Fuwa, N., Myojin, N., Nakamura, K., Toita, T., Saijo, S., et al. (2004) A Multi-Institutional Survey of the Effectiveness of Chemotherapy Combined with Radiotherapy for Patients with Nasopharyngeal Carcinoma. Japanese Journal of Clinical Oncology, 34, 569-583.
http://dx.doi.org/10.1093/jjco/hyh111
[26] Goto, Y., Kodaira, T., Fuwa, N., Mizoguchi, N., Nakahara, R., Nomura, M., et al. (2013) Alternating Chemoradiotherapy in Patients with Nasopharyngeal Cancer: Prognostic Factors and Proposal for Individualization of Therapy. Journal of Radiation Research, 54, 98-107.
http://dx.doi.org/10.1093/jrr/rrs071
[27] Chua, D.T., Ma, J., Sham, J.S., Mai, H.-Q., Choy, D.T.K., Hong, M.-H., et al. (2005) Long-Term Survival after Cisplatin-Based Induction Chemotherapy and Radiotherapy for Nasopharyngeal Carcinoma: A Pooled Data Analysis of Two Phase III Trials. Journal of Clinical Oncology, 23, 1118-1124.
http://dx.doi.org/10.1200/JCO.2005.12.081
[28] Park, K.H., Kim, J.S., Park, Y., Seo, H.Y., Park, Y.J., Choi, I.K., et al. (2010) Concurrent Chemoradiation Followed by Adjuvant Chemotherapy in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma in Korea. Cancer Chemotherapy and Pharmacology, 66, 643-651.
http://dx.doi.org/10.1007/s00280-009-1203-6
[29] Lee, A.W., Tung, S.Y., Chua, D.T., Ngan, R.K.C., Chappell, R., Tung, R., et al. (2010) Randomized Trial of Radiotherapy plus Concurrent-Adjuvant Chemotherapy vs Radiotherapy Alone for Regionally Advanced Nasopharyngeal Carcinoma. Journal of the National Cancer Institute, 102, 1188-1198.
http://dx.doi.org/10.1093/jnci/djq258
[30] Chen, Y., Sun, Y., Liang, S.B., Zong, J.-F., Li, W.-F., Chen, M., et al. (2013) Progress Report of a Randomized Trial Comparing Long-Term Survival and Late Toxicity of Concurrent Chemoradiotherapy with Adjuvant Chemotherapy versus Radiotherapy Alone in Patients with Stage III to IVB Nasopharyngeal Carcinoma from Endemic Regions of China. Cancer, 119, 2230-2238.
http://dx.doi.org/10.1002/cncr.28049
[31] Yang, A.K., Liu, T.R., Guo, X., Qi, G.L., Chen, F.J., Guo, Z.M., et al. (2008) Concurrent Chemoradiotherapy versus Radiotherapy Alone for Locoregionally Advanced Nasopharyngeal Carcinoma: A Meta-Analysis. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 43, 218-223.
[32] Zhang, L., Zhao, C., Ghimire, B., Hong, M.-H., Liu, Q., Zhang, Y., et al. (2010) The Role of Concurrent Chemoradiotherapy in the Treatment of Locoregionally Advanced Naso-Pharyngeal Carcinoma among Endemic Population: A Meta-Analysis of the Phase III Randomized Trials. BMC Cancer, 10, 558.
http://dx.doi.org/10.1186/1471-2407-10-558
[33] Langendijk, J.A., Leemans, C.R., Buter, J., Berkhof, J. and Slotman, B.J. (2004) The Additional Value of Chemotherapy to Radiotherapy in Locally Advanced Nasopharyngeal Carcinoma: A Meta-Analysis of the Published Literature. Journal of Clinical Oncology, 22, 4604-4612.
http://dx.doi.org/10.1200/JCO.2004.10.074
[34] He, A.J. (2011) Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiotherapy in the Treatment of Locally Advanced Nasopharyngeal Carcinoma. Hebei Medical Journal, 33, 2115-2116.
[35] Xu, M.J., Ye, J.M., Wu, L.Q. and Wang, X.C. (2011) Study of TPF Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiotherapy with Cisplatin in Locally Advanced Nasopharyngeal Carcinoma. Journal of Practical Oncology, 26, 291-294.
[36] Chen, X.J., Qiu, R.L., Yang, C.L. and Liu Y.Q. (2012) Study of TPF Neoadjuvant Chemotherapy Followed by Concurrent Intensity Modulated Radiochemotherapy in the Treatment for 30 Cases with Locally Advanced Nasopharyngeal Carcinoma. Chinese Journal of Clinical Oncology and Rehabilitation, 19, 201-204.
[37] Cui, J.D., Long, G.N., Zhang, Y., Li, T., Xu, Z.H., Wen, S.L. and Liang, C.L. (2012) Study of TPF Neoadjuvant Chemotherapy Followed by Concurrent Intensity Modulated Radiochemotherapy in the Treatment for 30 Cases with Locally Advanced Nasopharyngeal Carcinoma. Chinese Clinical Oncology, 17, 524-529.
[38] Fountzilas, G., Ciuleanu, E., Bobos, M., Kalogera-Fountzila, A., Eleftheraki, A.G., Karayannopoulou, G., et al. (2012) Induction Chemotherapy Followed by Concomitant Radiotherapy and Weekly Cisplatin versus the Same Concomitant Chemoradiotherapy in Patients with Nasopharyngeal Carcinoma: A Randomized Phase II Study Conducted by the Hellenic Cooperative Oncology Group (HeCOG) with Biomarker Evaluation. Annals of Oncology, 23, 427-435.
http://dx.doi.org/10.1093/annonc/mdr116
[39] Huang, S., Deng, G., Huang, G., Li, Y., Meng, Y. and Chen, J. (2012) Efficacy of Induction Chemotherapy Combined with Concurrent Chemoradiotherapy for Advanced Nasopharyngeal Carcinoma. Chinese Journal of Clinical Oncology, 39, 788-791.
[40] Liang, Z.-G., Zhu, X.-D., Tan, A.-H., Jiang, Y.-M., Qu, S., Su, F. and Xu, G.-Z. (2013) Induction Chemotherapy Followed by Concurrent Chemoradiotherapy versus Concurrent Chemoradiotherapy with or without Adjuvant Chemotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma: Meta-Analysis of 1,096 Patients from 11 Randomized Controlled Trials. Asian Pacific Journal of Cancer Prevention, 14, 515-521.
http://dx.doi.org/10.7314/APJCP.2013.14.1.515
[41] O’Meara, W.P. and Lee, N. (2005) Advances in Nasopharyngeal Carcinoma. Current Opinion in Oncology, 17, 225-230.
http://dx.doi.org/10.1097/01.cco.0000156197.29872.8e
[42] Kong, F., Cai, B.-Z., Chen, X.-Z., Zhang, J. and Wang, Y.-M. (2013) Prognostic Factors for Survival of Patients with Nasopharyngeal Carcinoma Following Conventional Fractionation Radiotherapy. Experimental and Therapeutic Medicine, 6, 57-60.
http://dx.doi.org/10.3892/etm.2013.1100
[43] Wu, S. and Zhao, C. (2000) The Impact of Radiotherapy Interruption and Time Delay on the Clinical Outcomes of Nasopharyngeal Carcinoma Patients. Chinese Journal of Cancer, 19, 923-926.

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.