Clinical Characteristics and Treatment Results of Nasopharyngeal Cancer

Kim, Hyeong Seok; Lee, Bong Jae; Kim, Sang Yoon

Abstract

BACKGROUND AND OBJECTIVES: Nasopharyngeal cancer (NPC) is a rare cancer with relatively poor prognosis because they tend to be diagnosed in the far advanced stage. Radiotherapy had been the treatment of choice; however, chemotherapy combined with radiotherapy has also been used to improve the treatment outcomes. The authors attempted to investigate the clinical characteristics and the prognostic factors, and also to evaluate the efficacy of combined chemotherapy.
MATERIALS AND METHODS
We analyzed 65 patients who were diagnosed with NPC and treated at Asan Medical Center. The cumulative survival rates according to various clinical factors were computed and compared using the Kaplan-Meier method and the Log-rank test.
RESULTS
The most common complaint was neck mass (43.1%), followed by hearing loss (15.4%), nasal obstruction (12.3%), epistaxis (10.8%), and headache (9.2%) in order of frequency. One fifth of patients had single or multiple cranial nerve defects at the time of diagnosis. The cumulative survival rates for 3-year period and 5-year period were 63.0%, and 53.6% respectively. The location of neck metastasis, distant metastasis, cranial nerve involvement, and the response to the initial treatment were significantly related with the survival rate. T and N stages proposed by AJCC (1988) did not affect the survival rates. There was no difference in the survival rates between radiotherapy and combined chemotherapy.
CONCLUSION
These results suggest that the TNM stagings proposed by AJCC (1988) might not be a good indicator in predicting the prognosis of NPC. The newer staging system which includes the location of neck metastasis should be preferred to predict the prognosis. The combination chemotherapy was not a superior method to radiotherapy in our cases, although a prospective controlled study is needed.