Published online May 28, 2015. doi: 10.5319/wjo.v5.i2.65
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.
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.