Nasopharyngeal carcinoma.
Nasopharyngeal carcinoma is usually present as locally advanced (stage III or IV) disease. Before 1980, the primary treatment was radiotherapy. The 5-year survival rate of patients with stage IVM0 across the world was less than 30%. Local, regional, and systemic recurrences are high in these patients and contributed to the poor survival. Sequential chemotherapy followed by radiotherapy (especially with the combination of cisplatin and 5-fluorouracil infusion for three courses) resulted in a 5-year survival rate of up to 55% in patients with stage IV disease. Concurrent single-agent cisplatin and radiotherapy improved 5-year survival rate to up to 55% in these patients. Total treatment with concurrent chemoradiotherapy followed by adjuvant cisplatin and 5-fluorouracil infusion resulted in 5-year survival rate of approximately 75%. Reversing the sequence of treatment by giving chemotherapy followed by concurrent chemoradiotherapy may improve the 5-year survival to up to 90%. In patients with recurrent disease or systemic metastases, the chances of salvage and long remission (many years) is approximately 15% to 20% with the use of adequate and effective chemotherapy. Newer agents, alone or concomitant with radiotherapy, are being evaluated in these patients.
Al-Sarraf
Muhyi
M
Rose Cancer Center, William Beaumont Hospital, 3577 West 13 Mile Road, Suite 404, Royal Oak, MI 48073, USA. mealsarraf@aol.com
Reddy
Maryada S
MS
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002274:Carcinogens, Environmental / Q000009:adverse effects; D002277:Carcinoma / Q000188:drug therapy / Q000209:etiology / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000209:etiology / Q000532:radiotherapy; D003131:Combined Modality Therapy / Q000379:methods; D019583:Dose Fractionation, Radiation; D020031:Epstein-Barr Virus Infections / Q000150:complications; D006801:Humans; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000209:etiology / Q000532:radiotherapy; D009367:Neoplasm Staging; D009385:Neoplastic Processes; D011878:Radiotherapy / Q000379:methods; D016019:Survival Analysis
D000970:Antineoplastic Agents; D002274:Carcinogens, Environmental