Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Otorhinolaryngol. May 28, 2015; 5(2): 65-70
Published online May 28, 2015. doi: 10.5319/wjo.v5.i2.65
Nasopharyngeal carcinoma: Long term follow-up of 83 patients
Ali Mardassi, Nabil Mathlouthi, Nawel Hlila, Chiraz Halouani, Sameh Mezri, Cyrine Zgolli, Ghassen Chebbi, Rania Ben Mhamed, Khemaies Akkari, Sonia Benzarti
Ali Mardassi, Nabil Mathlouthi, Nawel Hlila, Chiraz Halouani, Sameh Mezri, Cyrine Zgolli, Ghassen Chebbi, Rania Ben Mhamed, Khemaies Akkari, Sonia Benzarti, ENT Department, Military Hospital of Tunis, Tunis 1008, Tunisia
Author contributions: All authors contributed to the collection of data, the redaction of the manuscript and had approved this final version of the article.
Ethics approval: The study has been approved by the medical ethics committee of the military hospital, Tunis, Tunisia.
Informed consent: All the study participants provided informed written consent prior to study enrollment.
Conflict-of-interest: None.
Data sharing: Technical appendix, statistical code, and dataset available from the corresponding author at
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Ali Mardassi, MD, ENT Department, Military Hospital of Tunis, Montfleury, Tunis 1008, Tunisia.
Telephone: +216-22-552252
Received: September 27, 2014
Peer-review started: September 28, 2014
First decision: January 8, 2015
Revised: February 13, 2015
Accepted: March 5, 2015
Article in press: March 9, 2015
Published online: May 28, 2015

AIM: To analyzes the clinical, paraclinical, therapeutical and evolutive features of nasopharyngeal carcinoma (NPC).

METHODS: All the patients treated for a nasopharyngeal carcinoma between 2000 and 2013 in the Ear-Nose-Throat Department of the Military Hospital of Tunis, Tunisia were collected in this study. Eighty-three patients signed a written consent prior to study enrollment. The gender ratio (M/W) was 6.5 with a median age of 49 years (range 16-85). The median follow up time was 37 mo (18 to 108 mo). The evolution, during and after the end of therapy, was assessed on clinical biological and radiological exams. Different parameters were analyzed and compared to other series: complications of chemo and radiotherapy, recurrence of the disease, metastasis and overall survival rate.

RESULTS: Of the 83 patients of our study, 15% had T1 tumors, 20% had T2, 23% had T3 and 41% had T4 disease. At the time of diagnosis, 14% of the patients had a cranial nerve deficit. Only 12 patients had exclusive radiotherapy and the remaining of our patients had concomitant radio chemotherapy. Iatrogenic complications were diagnosed in 53% of the cases: radioepithelitis (28%), radiodermatitis (9%), xerostomia (17%), osteoradionecrosis (3%), cerebral radionecrosis (1%) and a pancytopenia (17%). The follow-up period varied from 18 to 108 mo (average: 37 mo). During the first six months after treatment, a persistence of the disease was found in 11% of patients, while a recurrence of the cancer was diagnosed in 6% and distant metastasis developed in 14% of the patients. Fifteen patients needed remedial chemotherapy for a relapse or metastasis and five had palliative chemotherapy for very advanced cases. We report 3 cases of death during the follow-up.

CONCLUSION: Despite its excellent radio-chemotherapy response, and general good prognosis, a careful follow-up of patients with NPC is necessary to detect and manage any iatrogenic complication, locoregional recurrence or metastasis of the disease.

Keywords: Nasopharyngeal carcinoma, Cranial nerve, Radiotherapy, Chemotherapy, Metastasis

Core tip: The carcinoma of the nasopharynx (NPC) is a particular form of cervico-facial cancers by its anatomic location, distinct pathologic features, ethnic pathogenesis and specific clinical outcome. This tumor is thought to have a good prognosis especially in undifferentiated and locally noninvasive forms. In this paper, we report our experience in the management of NPC and we report our results and complications during and after the end of therapy.