Nasopharyngeal carcinomas: prognostic factors and treatment features.
OBJECTIVE
We retrospectively evaluated the clinical, radiological and pathological features determining the prognosis of patients with nasopharyngeal carcinoma in Ankara Oncology Hospital, Turkey.


METHODS
Two hundred and fifty-nine patients, 74 women and 185 males with nasopharyngeal carcinoma were treated between 1993 and 2008. All imaging data including CT and MRI were reevaluated according to the criteria which determine parapharyngeal, oropharyngeal, nasal, skull-base (bone)/sinus, infratemporal fossa, orbit, intracranial involvements and lymph node metastasis by our radiologists. The patients were restaged using the AJCC 2002 classification with these new radiological findings and clinical data base. We evaluated prognostic factors using univariate Kaplan- Meier and multivariate Cox regression analyses. Gender, age (40-year cut-off), histology, T- and N-stage, tumor size, regional involvement, radiotherapy and/or chemotherapy and response to therapy were studied as variables.


RESULTS
Five-year disease-free and overall survival rates were 45 +/- 4 % and 72 +/- 3 % , respectively. We found that age, gender, WHO type, radiotherapy and/or chemotherapy, N-stage and response to therapy were significant prognostic factors on disease-free survival and overall survival. In the chemo-radiotherapy group, we did not detect any survival difference between patients given four or fewer chemotherapy courses.


CONCLUSIONS
Radiotherapy improved survival but chemotherapy, in the neoadjuvant and adjuvant setting, had no added effect to radiotherapy. N-stage and response to treatment were the most important independent predictors on survival. Age, gender, type, therapy and bone/sinus involvement were among the predictive factors on multivariate analysis, as well.


BACKGROUND
Nasopharyngeal carcinoma - Prognostic factor - MRI - CT - Radiotherapy - Chemotherapy.
Aribas
Bilgin Kadri
BK
The Departments of Radiology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
Cetindag
Faik
F
Ozdogan
Zafer
Z
Dizman
Aysen
A
Demir
Pelin
P
Unlu
Dilek Nil
DN
Yologlu
Zeynel
Z