title: Nasopharyngeal carcinoma - an update of treatment and acute radiation induced reactions from a tertiary-care hospital in Pakistan.
abstract: BACKGROUND
  Nasopharyngeal carcinoma (NPC) is a diverse entity with a multi-factorial etiology and a distinct racial and geographical distribution. It is curable if diagnosed and treated early.
  
  
  METHODS
  This descriptive study covered 30 patients who underwent radiotherapy (RT) for nasopharyngeal malignancies during February 2006 till November 2010 at the Department of Radiation Oncology, Aga Khan University Hospital (AKUH), Karachi.
  
  
  RESULTS
  Thirty cases of nasopharyngeal tumors were registered; a case of embryonal rhabdomyosarcoma and another of diffuse large B-cell lymphoma were not included in the final analyses. There were 20 (71.0%) males and 8 (29.0%) females, 2 and 5 being observed in adolescents. The mean age of the male and female patients was 43.7 [SD 20.1] and 30.3 years [SD 17.9], respectively. Nodal involvement was seen in 23 cases and cranial in 8. Almost two-thirds the patients presented with a stage IV disease and all but two received chemotherapy. Electrons or photons were used for 23 cases; low anterior neck field was used in 25 cases. The doses of radiotherapy delivered ranged between 2000cGy to 7400cGy, the lower ones being given for palliation only. Once spinal cord tolerance was reached, electron boost fields were used in order to treat the posterior neck. A nasogastric tube was required for feeding in 2 (10.0%) male and 2 (25.0%) female patients; gastrostomy was needed for 1 (5.0%) patient. Radiotherapy (RT) induced reactions were observed in 90% of the patients, but were mild in most cases.
  
  
  CONCLUSIONS
  In the presence of clinician based expertise and technical constraints in Pakistan, nasopharyngeal tumors are still being treated optimally with the need of creating a better awareness in public for early detection.
authors.affiliation: Department of Radiation Oncology, Aga Khan University Hospital, Karachi, Pakistan E-mail : yasmin.bhurgri@gmail.com.
authors.forename: Ahmed Nadeem
authors.initials: AN
authors.lastname: Abbasi
authors.forename: Sumaiya
authors.initials: S
authors.lastname: Zahid
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Bhurgri
authors.forename: Nasir
authors.initials: N
authors.lastname: Ali
authors.forename: Farrok
authors.initials: F
authors.lastname: Karsan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D010154:Pakistan; D011836:Radiation Tolerance; D011855:Radiodermatitis / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult