Dedication

Abdullah, Baharudin; Balasubramanian, Anusha; Lazim, Norhafiza Mat

doi:10.1016/b978-0-12-814403-9.00019-7

Cited by 1 publication

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“…3 NPC is challenging to diagnose early due to nonspecific symptoms, including neck lumps, bloody saliva, hearing loss, nosebleeds, nasal congestion, tinnitus, and cranial nerve palsies. 2,4,5 It is usually diagnosed by endoscopy followed by biopsy of the nasopharyngeal epithelium. Other diagnostic modalities include computed tomography (CT) scan, magnetic resonance imaging (MRI), detection of EBV on biopsied sample or plasma, laboratory tests, and audiometry to evaluate hearing.…”

Section: Introductionmentioning

confidence: 99%

The role of locoregional radiotherapy in distant metastatic nasopharyngeal carcinoma cases

Mayangsari,

Rahman,

Adham

et al. 2024

Oto Rhino Laryn Indones

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Background: Nasopharyngeal carcinoma (NPC) is a highly metastatic head and neck cancer primarilytreated with platinum-based chemotherapy. The oligometastasis hypothesis proposed by Hellman andWeichselbaum suggested that controlling the primary tumor through locoregional radiotherapy couldsignificantly improve prolonged disease-free survival. Purpose: To evaluate the effectiveness of combining locoregional radiotherapy with chemotherapy for metastatic NPC. Case series report: The first case involved a 57-year-old male with NPC at T4N3M1 (lungs) with partial response to chemotherapy, who then underwent concurrent chemoradiotherapy. However, his condition deteriorated after completing chemoradiation. The second case featured a 56-year-old male with NPC at T4N3M1 (liver), exhibiting partial response to chemotherapy and remaining at a stable condition after concurrent chemoradiotherapy. Method: Using specific keywords based on clinical questions in the PubMed, Cochrane, EBSCOhost, and Proquest databases. Inclusion criteria, exclusion criteria, and critical appraisal were carried out to find relevant studies. Result: Eleven articles were appraised critically based on the Oxford Centre for Evidence-based Medicine (CEBM) worksheet and include the validity, importance, and applicability in clinical scenarios. Conclusion: Metastatic NPC patients had better overall survival outcomes when treated with locoregional radiotherapy and systemic chemotherapy. Predictive factors influencing survival included oligometastasis, locoregional radiotherapy, chemotherapy response, lactate dehydrogenase, C-reactive protein, EBV DNA, total chemotherapy administration, Karnofsky performance score, number of metastatic lesions, and liver metastases. Platinum-based chemotherapy combined with locoregional radiotherapy could be considered as a management approach for cases of oligometastatic NPC.Keywords: nasopharyngeal carcinoma, chemotherapy, metastasis, overall survival, radiotherapy

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