Epidemiology and Outcomes of Nasopharyngeal Carcinoma

Abstract

Nasopharyngeal carcinoma (NPC) is a rare head and neck neoplasm worldwide. It is common among the southern Chinese with significant geographical variation with the highest incidence being in Southeast Asia up to 6.4/100,000 males and 2.4/100,000 females in these regions and the Epstein Barr virus (EBV) is associated closely with NPC. This disease has peculiarities in its etiopathogenesis, presentation, risk of nodal and distant metastasis, response to therapy and overall survival (OS) outcomes that stand out as compared to other head and neck cancer subsites. NPC is mainly treated by RT and is profoundly radiosensitive and radiotherapy treatment is the spine of treatment for all stages of NPC without far off metastases. Many advances in RT techniques and schedules are attempted to improve outcomes of the disease starting from intracavitary brachytherapy, intensity modulated RT to simultaneous modulated accelerated RT, all showing some promise with most significant benefit seen with addition of chemotherapy, especially in intermediate (Stage II) and advanced (Stage III, IVA, IVB) cases. At a time when modern radiation treatment like intensity-modulated radiotherapy (IMRT) are accomplishing great good local control, distant metastases are getting to be the transcendent design of treatment failure, particularly in patients with locally progressed illness. There are numerous results from clinical trials looking at combined radiation treatment (RT) and chemotherapy for NPC. Survival rates significantly differ between NPC patients according to stages of disease.