SEOM-TTCC clinical guideline in nasopharynx cancer (2021)

Domı́nguez, A.; Cirauqui, Beatriz; Castaño, Almudena García; Cabellos, R. Alvarez; Maseda, Alberto Carral; Fernández, Beatriz Castelo; Rey, Leticia Iglesias; Rubió‐Casadevall, Jordi; Arrazubi, Virginia; Mesı́a, Ricard

doi:10.1007/s12094-022-02814-x

Cited by 9 publications

(5 citation statements)

References 66 publications

(68 reference statements)

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“…This finding aligns with the literature, which identifies a differential age distribution of NPC in low-incidence regions compared to endemic regions. In low-incidence regions, the epidemiological pattern of NPC incidence demonstrates a bimodal distribution, with peaks observed in adolescent and young adult cohorts and a secondary increase in prevalence noted beyond the age of 65 years [10]. In stark contrast, endemic regions present a distinctly different profile, where the incidence of NPC begins to climb post-30 years of age, reaching a peak incidence within the 40-59 age group before experiencing a decline [11].…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of Treatment Outcomes and Associated Factors in Nasopharyngeal Cancer Patients at a Tertiary Cancer Center in the United Arab Emirates

Bin Sumaida,

Shanbhag,

Aby Ali

et al. 2024

Cureus

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Background and objectiveNasopharyngeal carcinoma (NPC) presents a complex epidemiological pattern influenced by demographic characteristics, risk factors such as Epstein-Barr virus (EBV) infection, and smoking. Understanding the clinical profile and optimizing treatment strategies for NPC requires comprehensive analyses of these factors. In light of this, this study aimed to analyze the epidemiological patterns, histological characteristics, and treatment outcomes of NPC patients diagnosed and treated at a single center from 2016 to 2023. Materials and methodsThis retrospective study was conducted at Tawam Hospital in the United Arab Emirates (UAE), focusing on patients diagnosed with NPC. It involved the analysis of patient age distribution to identify epidemiological patterns, histological examination to classify NPC types according to WHO guidelines, and evaluation of treatment outcomes based on induction chemotherapy regimens and concurrent chemoradiotherapy protocols. The effectiveness of various chemotherapy combinations, particularly cisplatin and 5-fluorouracil (Cis+5FU), was assessed alongside the integration of advanced radiotherapy techniques like intensitymodulated radiotherapy (IMRT). ResultsIn this study of 41 NPC patients, the age distribution varied widely, ranging from 10 to 74 years, with a mean age of >40 years. There was a significant male predominance (82.93%). Most patients were non-smokers (68.29%) and did not consume alcohol (92.68%), and there was a high prevalence of EBV positivity (100%). At diagnosis, 80.49% had no metastases. The primary treatment was chemotherapy induction, with a 73.17% uptake and a 92.68% completion rate, leading to a 65.85% complete response (CR) rate. No significant association was found between smoking status and treatment response (p=0.7657). Pathologically, nonkeratinizing undifferentiated squamous carcinoma was the most common variant (75.61%). The Cis+5FU regimen was the most frequently employed method (56.67%), associated with a 76.47% CR rate. Concurrent chemotherapy was administered to 87.80% of patients, with the weekly Cis regimen being the most used one (56.09%), resulting in a significant CR rate. Combining radiation therapy with concurrent and induction chemotherapy yielded high CR rates (RT+cCT: 66.66%, RT+cCT+iCT: 80%). Survival analysis revealed the highest 36-month survival rate (46.43%) in the RT+cCT+iCT group, suggesting a potential benefit from incorporating induction chemotherapy into the treatment regimen. ConclusionsThis study illustrates the impact of demographic variables, EBV infection, and smoking on the development and treatment outcomes of NPC. It points to the success of customized chemotherapy and advanced radiotherapy strategies. Yet, it is limited by its retrospective nature and single-center focus, and hence we recommend multicentric studies to broaden the applicability of the results and improve NPC treatment approaches for varied patient groups.

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Section: Discussionmentioning

confidence: 99%

An Evaluation of Treatment Outcomes and Associated Factors in Nasopharyngeal Cancer Patients at a Tertiary Cancer Center in the United Arab Emirates

Bin Sumaida,

Shanbhag,

Aby Ali

et al. 2024

Cureus

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“…The treatment methods, radiation doses, cancer staging, and radiation fields of patients with and without NPC with HNC considerably differ. Chemoradiation is the primary treatment for NPC [ 32 ], whereas surgery combined with chemoradiation is crucial for non-NPC HNC patients [ 33 ]; a study indicated that surgery and higher radiation doses to the neck may lead to damage in the carotid arteries [ 8 ]. A previous study showed that some chemotherapeutic agents, such as cisplatin and 5-Fluorouracil, may cause damage to endothelial cells and may induce local thrombosis [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Carotid Blowout Syndrome in Patients with Head and Neck Cancer after Radiation Therapy: A Cohort Study

Jiang,

Chang,

Yeh

et al. 2024

Diagnostics

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Carotid blowout syndrome (CBS) is a rare yet life-threatening complication that occurs after radiation therapy (RT). This study aimed to determine the incidence of CBS in patients with head and neck cancer (HNC) undergoing contemporary RT and to explore potential discrepancies in the risk of CBS between nasopharyngeal cancer (NPC) and non-NPC patients. A total of 1084 patients with HNC who underwent RT between 2013 and 2023 were included in the study. All patients were under regular follow-ups at the radio-oncology department, and underwent annual contrast-enhanced computed tomography and/or magnetic resonance imaging for cancer recurrence surveillance. Experienced neuroradiologists and vascular neurologists reviewed the recruited patients’ images. Patients were further referred to the neurology department for radiation vasculopathy evaluation. The primary outcome of this study was CBS. Patients were categorized into NPC and non-NPC groups and survival analysis was employed to compare the CBS risk between the two groups. A review of the literature on CBS incidence was also conducted. Among the enrolled patients, the incidence of CBS in the HNC, NPC, and non-NPC groups was 0.8%, 0.9%, and 0.7%, respectively. Kaplan–Meier analysis revealed no significant difference between the NPC and non-NPC groups (p = 0.34). Combining the findings for our cohort with those of previous studies revealed that the cumulative incidence of CBS in patients with HNC is 5% (95% CI = 3–7%) after both surgery and RT, 4% (95% CI = 2–6%) after surgery alone, and 5% (95% CI = 3–7%) after RT alone. Our findings indicate a low incidence of CBS in patients with HNC undergoing contemporary RT. Patients with NPC may have a CBS risk close to that of non-NPC patients. However, the low incidence of CBS could be a potentially cause of selection bias and underestimation bias.

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“…Multiple international guidelines [ 17 , 18 , 19 ] are available regarding the treatment of NPC. Endemic EBV-positive non-keratinising undifferentiated NPC is both radiosensitive and chemosensitive; thus, they have formed the cornerstone of treatment for NPC patients.…”

Section: Current Diagnosis Staging and Treatment Optionsmentioning

confidence: 99%

Precision Medicine for Nasopharyngeal Cancer—A Review of Current Prognostic Strategies

Suryani,

Lee,

Teo

et al. 2024

Cancers

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Nasopharyngeal carcinoma (NPC) is an Epstein–Barr virus (EBV) driven malignancy arising from the nasopharyngeal epithelium. Current treatment strategies depend on the clinical stage of the disease, including the extent of the primary tumour, the extent of nodal disease, and the presence of distant metastasis. With the close association of EBV infection with NPC development, EBV biomarkers have shown promise in predicting treatment outcomes. Among the omic technologies, RNA and miRNA signatures have been widely studied, showing promising results in the research setting to predict treatment response. The transformation of radiology images into measurable features has facilitated the use of radiomics to generate predictive models for better prognostication and treatment selection. Nonetheless, much of this work remains in the research realm, and challenges remain in clinical implementation.

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SEOM-TTCC clinical guideline in nasopharynx cancer (2021)

Cited by 9 publications

References 66 publications

An Evaluation of Treatment Outcomes and Associated Factors in Nasopharyngeal Cancer Patients at a Tertiary Cancer Center in the United Arab Emirates

An Evaluation of Treatment Outcomes and Associated Factors in Nasopharyngeal Cancer Patients at a Tertiary Cancer Center in the United Arab Emirates

Incidence of Carotid Blowout Syndrome in Patients with Head and Neck Cancer after Radiation Therapy: A Cohort Study

Precision Medicine for Nasopharyngeal Cancer—A Review of Current Prognostic Strategies

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