Analysis of 1379 patients with nasopharyngeal carcinoma treated by radiation

Abstract

One thousand three hundred seventy-nine nasopharyngeal carcinoma (NPC) patients were treated from March 1958 to December 1978. Twenty-two percent had stage I or II and 78% Stage III or IV had lesions. Two hundred twenty-Kv radiographs were used before 1960; and telecobalt was used from 1961 to 1978. Factors influencing the 5-year survival rate favorably are youth of patient, being female, pathologic condition (poorly differentiated carcinoma, 45.1% versus adenocarcinoma, 13%), stage (Stage I, 86%, Stage II, 59.5%; Stage III, 45.8%; Stage IV, 29.2%), decade admitted for treatment in the past (31% in the 1950s, 48.6% in the 1970s), total dose delivered to the nasopharynx (40 to 49 Gy, 46%; 70 to 79 Gy, 54.1%; 90 Gy or more, 64%) and prophylactic radiation to the neck regions (with prophylactic irradiation, 53.8%, without prophylactic irradiation, 23%). This implies that prophylactic radiation of the neck is crucial even without positive clinical metastasis. For those who have a residual tumor in the primary site when 70 Gy has been delivered, the total dose may be boosted to more than 90 Gy with the cone-down technique or on basis of adding 20 Gy to the dose at which the primary lesion disappeared grossly. The common postirradiation complications are: radiation myelitis, trismus, and otitis media. Because disease recurred in some patients after the fifth year, NPC patients should be followed for at least 10 years.

Radiation‐related cranial nerve palsy in patients with nasopharyngeal carcinoma

“…6 In an analysis of 1379 patients from China, no cranial nerve palsy was mentioned despite the finding that 18.4% of patients had radiation encephalomyelopathy. 17 In the current analysis, we did not intend to determine the incidence of cranial nerve palsy, because most of our patients were referred from other hospitals, and the diagnosis of certain cranial neuropathy may be difficult, as discussed below.…”

Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: Penang General Hospital Experience

“…The 5 years overall survival (OS) reported in Penang General Hospital, Malaysia for a cohort of 285 patients treated between 2000-2005 was only 33.3% ( Phua et al, 2011). This result was relatively poor compared to the overall worldwide 5 years survival rate which ranged from 32% to 62% involving more than 9500 patients with all stages of NPC (Shu-Chen, 1980;Hsu et al, 1982;Al-Sarraf et al, 1990;Lee et al, 1992;Lee et al, 1993;Qin et al, 1998;Wang et al, 1998;Ali et al, 1999;Lin et al, 1999, Terence et al, 2003. The results published for later studies were even better with the advent of new radiotherapy techniques including intensity-modulated radiotherapy (IMRT).…”

Mc-hES, a novel plasmid carrying human endostatin gene, inhibits nasopharyngeal carcinoma growth

“…1 The expression of endostatin protein and transcript can be detected from day 3 to day 20 in the mc-hES group after one injection. But in the pcDNA-hES group, it was detectable on day 3 then decreased sharply and was barely detectable on day 7 and undetectable on day 14.…”

“…Although NPC is a radiosensitive tumor, only 10-40% of cases presenting with advanced disease survive 5 years. 1,2 Moreover, once metastasis has developed, 85% of patients die within 1 year. 2,3 It is therefore necessary to develop additional forms of treatment for NPC.…”