Complete response with combined therapy in a patient with brain metastasis from nasopharyngeal carcinoma: case report and literature review

Abstract

Brain metastasis of nasopharyngeal carcinoma (NPC) is a rare event with limited research. In this report, we discuss the details of a case of brain metastasis from NPC that presented with a solitary, cystic lesion in the frontal lobe. We also reviewed the related literature published in the last 20 years. We analyzed the patient’s clinical characteristics, which indirectly suggested hematogenous spread rather than a cerebrospinal fluid route. Although there are no standard treatments for brain metastasis of NPC, previous studies reported that combined surgery and radiotherapy was a good treatment option, with long survival. Our patient achieved intracranial complete response after the combination of conventional chemoradiotherapy and novel immunotherapy. This treatment option could be useful in future similar cases.

Clinical characteristics and prognostic factors in nasopharyngeal carcinoma with brain metastasis: A retrospective, single‐center study

“…Distant metastasis is currently the main cause of treatment failure in NPC 16 . Brain metastasis in NPC is extremely rare in clinical practice, with reported incidence rates ranging from 0.3% to 0.7% 9–14 . Our study found that the rate of brain metastasis in NPC was only 41 cases out of 81 496 cases (0.5‰).…”

“…16 Brain metastasis in NPC is extremely rare in clinical practice, with reported incidence rates ranging from 0.3% to 0.7%. [9][10][11][12][13][14] Our study found that the rate of brain metastasis in NPC was only 41 cases out of 81 496 cases (0.5‰). Despite its low occurrence, our study demonstrated that these patients experienced a devastating condition, with a median OS of 11.2 months.…”

“…However, there is still controversy regarding the route of brain metastasis in NPC. Previous reports have indicated that most cases of brain metastases from NPC were concurrent with other organ metastases 9,14,22 ; thus scholars consider that in such cases, brain metastases from NPC may occur hematogenously. Our study results also support the hematogenous route for brain metastasis in NPC.…”

“…A search of the PubMed database within the available English literature uncovered a limited number of welldescribed cases of brain metastasis in NPC, and no studies have systematically explored the treatment and prognosis of this condition. [9][10][11][12][13][14] Therefore, we screened patients with brain metastasis from a large population using an NPC-specific dataset, aiming to improve the management of this particular subset by investigating the clinicopathological characteristics, treatment modalities, and prognostic factors.…”

Nomogram model of survival prediction for nasopharyngeal carcinoma with lung metastasis: developed from the SEER database and validated externally

“…Unfortunately, there is currently no consensus on diagnosing brain metastasis in NPC. In some cases, individual patients have been reported to have achieved a good survival prognosis through chemoradiotherapy ( 34 ) ( 35 ). Although brain metastases from NPC are rare, they cannot be ignored, and these patients may need more mature treatment options to help them survive for a long time.…”