title: Refractory lympho-epithelial carcinoma of the nasopharynx: a case report illustrating a protracted clinical course.
abstract: 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.
authors.affiliation: 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.
authors.forename: Frederick Y
authors.initials: FY
authors.lastname: Wu
authors.affiliation: Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Eddy S
authors.initials: ES
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Willey
authors.affiliation: Department of Pathology, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Ely
authors.affiliation: Department of Otolaryngology, Voice Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Gaelyn
authors.initials: G
authors.lastname: Garrett
authors.affiliation: Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Cmelak
mesh_terms: 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