Refractory lympho-epithelial carcinoma of the nasopharynx: a case report illustrating a protracted clinical course.
Nasopharyngeal carcinoma is an uncommon cancer in North America. Its clinical course is typified by locally advanced disease at diagnosis and has a high propensity for both regional and distant spread. It is, therefore, typically treated with a combination of radiation and chemotherapy. This report describes our 10-year clinical and radiological findings in a 48-year-old Vietnamese male patient with locally-advanced T4N1M0 lympho-epithelial carcinoma of the nasopharynx. Despite a long remission period after his initial course of aggressive chemoradiation, his tumor recurred locally after 4 years. Thereafter, throughout a period of over 10 years, he has been treated with multiple courses of re-irradiation and three different trials of chemotherapy. He was ultimately provided with over 30 months of progression-free tumor control with the epidermal growth factor receptor (EGFR)-inhibitor cetuximab. This case illustrates the commonly protracted course of this disease and its responsiveness to multiple treatment modalities.
Wu
Frederick Y
FY
Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA.|Department of Radiation Oncology, University of California at San Francisco, San Francisco, CA, USA.
Yang
Eddy S
ES
Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Willey
Christopher D
CD
Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Ely
Kim
K
Department of Pathology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Garrett
Gaelyn
G
Department of Otolaryngology, Voice Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
Cmelak
Anthony J
AJ
Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA.
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed