End Results of Treatment of Malignant Lesions of the Nasopharynx

Abstract

In most reports on the treatment of malignant tumors of the nasopharynx it is stated that the results are poor, and from some it would seem that little benefit is obtained from any form of treatment. Furstenberg,1 in reporting 40 cases of malignant tumors of the nasopharynx, concluded "that treatment is exceedingly futile and the prognosis hopelessly discouraging." Other authors have recorded more optimistic results. In 1922 one of us (New 2) described the syndrome that these tumors present and later reported the pathologic and neurologic aspects of the lesions ; so this discussion will deal only with the results of treatment.In order to determine the end results of the treatment of malignant tumors of the nasopharynx, a review of the history and microscopic pathology and a follow-up study of the patients treated prior to 1937 have been made. In all, 271 patients suffering from malignant lesions of the nasopharynx received treatment. Biopsy was made in all cases and revealed evidence of a malignant process except in 37 cases. In these 37 cases there was a definite clinical picture of malignant disease, but one biopsy did not reveal the malignant cells. However, the subsequent course of the disease confirmed the clinical diagnosis. Only the tumors originating in the nasopharynx are considered in this study. The extrinsic tumors are not included. This distinction is adhered to as closely as possible. Most of the malignant tumors of the nasopharynx are epitheliomas, and usually high grade squamous cell epitheliomas grade 4 (Broders' method), which, fortunately, are radiosensitive. Table 1 shows the types of lesions present in the entire series.The epitheliomas usually appear as ulcerated lesions, frequently in Rosenm\l=u"\ller's fossa, while the lymphosarcomas are large, bulky tumors. Table 2 shows the age and sex of the patients. The youngest patient was 4 years and the oldest 80 years of age. The average age of all the patients treated was 43.3 years. Almost two thirds of the treated patients were in the age group from 30 to 59 years.

Isolated Nasopharyngeal Hodgkin's Disease Presenting as Nasal Obstruction

“…Symptoms of nasopharyngeal involvement include nasal obstruction, snoring, epistaxis, deafness and cranial nerves palsies 12,14,16,18 . Two more unusual presentations of nasopharyngeal Hodgkin's disease with intracranial involvement 19 and pituitary insufficiency due to erosion of the sella turcica 16 have been reported.…”

Klinik virusbedingter Tumoren

“…In zahlreichen Publikationen wurde liber verschiedenste Verfahren der Strahlentherapie, wie R6ntgenstrahlen, Radium und Kobalt 60 sowie fiber ihre Ergebnisse berichtet. Nach der Literatur kann man davon ausgehen, daB die 5-Jahres-Uberlebensrate nach konventioneller Strahlentherapie einschlieBIich der lokalen Anwendung von Radium zwischen 7% und 25% lag [138,292,294,345]. Dagegen waren die 5-Jahres-Behandlungsergebnisse mit Kobalt 60 deutlich besser.…”