Nasopharyngeal carcinoma

Abstract

Nasopharyngeal carcinoma is usually present as locally advanced (stage III or IV) disease. Before 1980, the primary treatment was radiotherapy. The 5-year survival rate of patients with stage IVM0 across the world was less than 30%. Local, regional, and systemic recurrences are high in these patients and contributed to the poor survival. Sequential chemotherapy followed by radiotherapy (especially with the combination of cisplatin and 5-fluorouracil infusion for three courses) resulted in a 5-year survival rate of up to 55% in patients with stage IV disease. Concurrent single-agent cisplatin and radiotherapy improved 5-year survival rate to up to 55% in these patients. Total treatment with concurrent chemoradiotherapy followed by adjuvant cisplatin and 5-fluorouracil infusion resulted in 5-year survival rate of approximately 75%. Reversing the sequence of treatment by giving chemotherapy followed by concurrent chemoradiotherapy may improve the 5-year survival to up to 90%. In patients with recurrent disease or systemic metastases, the chances of salvage and long remission (many years) is approximately 15% to 20% with the use of adequate and effective chemotherapy. Newer agents, alone or concomitant with radiotherapy, are being evaluated in these patients.

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

“…When external beam radiation is the chosen treatment modality for oral carcinoma with N0 neck, National Comprehensive Cancer Network (NCCN) has recommended a total dose of 70Gy to primary tumor and ≤ 50Gy to the neck at risk of occult metastasis. Both chemotherapy and radiotherapy may be associated with complications and this may be more marked in instances of poor pre-treatment evaluation and preparation [2,5,9,19].…”

Buffer Optimization for Cynodon dactylon Proteome

“…Radiation therapy is often performed in patients with unresectable cancer or patients in whom surgery is considered difficult because of older age or comorbidities. However, since 1992, the efficacy of CRT has been well documented, and CRT has been clearly shown to improve cure rates compared with radiotherapy alone [1,2,[5][6][7][8][9]. Currently, the guidelines of the National Comprehensive Cancer Network recommend CRT for esophageal cancer such as medically unfit for surgery or surgery not elected case [3].…”

“…Concurrent chemoradiotherapy (CRT) has been reported to significantly increase the survival rate of patients with esophageal cancer as compared with radiation therapy alone [1,2]. CRT is proposed to be the standard treatment for advanced esophageal cancer [3].…”

The Effects of a 6-Month Tai Chi Qigong Training Program on Temporomandibular, Cervical, and Shoulder Joint Mobility and Sleep Problems in Nasopharyngeal Cancer Survivors

“…1 Currently, the primary medical management for NPC is radiotherapy, while chemotherapy and surgery (eg, nasopharyngectomy) are elective treatments. 2 Although previous research has shown that these aggressive treatment methods can successfully control tumors and thus increase overall survival rates, 1 survivors generally experience many associated side effects, such as neck muscle fibrosis, 3,4 trismus or restricted mouth opening, 5,6 and shoulder dysfunctions. 7 The disease can also directly cause chronic symptoms, such as pain and fatigue.…”