A retrospective study on 100 nasopharyngeal carcinoma patients

Abstract

Objective: The aim of this retrospective study was to analyse the survival and recurrens patterns of 100 non-metastatic nasopharyngeal carcinoma patients. Materials and methods: A retrospective study in 100 nasopharyngeal carcinoma patients treated between 1991 and 2003 was performed. 76 received cisplatin based neoadjuvant chemotherapy for two or four courses prior to definitive radiotherapy and 24 were treated by radical radiotherapy alone. The total dose delivered to nasopharynx, lymph nodes and servical region (if affected) was 66-70 Gy, 50 Gy and 15-20 Gy respectively.Results: Twenty patients had stage II, 47 had stage III and 33 had stage IV disease (according to AJCC 1997 staging system). All patients were diagnosed as nasopharyngeal squamous cell carcinoma (18 WHO I-II and 82 WHO III). Minimum follow-up period was two years. Overall response after induction chemotherapy was 75% (with 13.2% complet response and 61.8% partial response). 13 patients had stable disease (17.1%), whereas 6 patients (7.9%) had progressive disease. Failure rate after radiotherapy was 53%. Locoregional recurrence was 56.6%, locoregional recurrence and distant failure was 28.3% and isolated distant failure was 15.1%. The five years overall survival was 57.1% for radiotherapy alone and 57.7% for the chemoradiotherapy.Conclusion: Induction chemotherapy neither improved the teratment outcome nor altered the failure patterns in patients with nasopharyngeal carcinoma.

Özet

Amaç: Bu retrospektiv çalışmanın amacı, nonmetastatik nazofarengeal karsinomlu 100 hastanın survi ve rekürrens paternini analiz etmekti. Gereç ve yöntem : 1991-2003 yılları arasında tedavi edilen 100 nazofarengeal karsinomlu hasta retrospektif olarak incelendi. 24'ü yalnız radyoterapi ile tedavi edilirken, 76'sına kombine model tedavi (cisplatin bazlı 2-4 kür neoadjuvant kemoterapi ve radyoterapi) uygulanmıştı. Nazofarengeal bölgeye 66-70 Gy, lenf nodlarına 50 Gy, servikal hastalık mevcut ise tutulan alana 15-20 Gy boost dozu verilmişti.Bulgular: AJCC 1997 evreleme sistemine göre, hastaların 20'si evre II, 47'si evre III, 33'ü evre IV'tü. Tüm hastalar skuamoz hücreli nazofarengial karsinom tanısı almıştı (18 WHO I-II, 82 WHO III). Minimum takip süresi 2 yıldı. İndüksiyon kemoterapisine yanıt oranı %75 (%13,2 tam ve %61,8 kısmi), yanıtsız olanların oranı (progresif hastalık) %7,9 ve stabil hastalık oranı %17,1'di. Radyoterapi sonrası başarısızlık oranı %53'tü. Bunların %56,6'sı lokoregional nüks, %28,3'ü lokoregional nüks ve uzak metastaz ve %15,1'i izole metastazdı. 5 yıllık genel sağ kalım yalnız radyoterapi verilenlerde %57,1, kombine tedavi verilenlerde %57,7 idi.Sonuç: İndüksiyon kemoterapisi nazofarengeal karsinomlu hastalarda tedavi sonuçlarını ve başarısızlık paternini değiştirmemiştir.