title: Primary treatment results of Nasopharyngeal Carcinoma (NPC) in Yogyakarta, Indonesia.
abstract: BACKGROUND
  Nasopharyngeal Carcinoma (NPC) is a major health problem in southern and eastern Asia. In Indonesia NPC is the most frequent cancer in the head and neck area. NPC is very sensitive to radiotherapy resulting in 3-year disease-free and overall survival of approximately 70% and 80%, respectively. Here we present routine treatment results in a prospective study on NPC in a top referral; university hospital in Indonesia.
  
  
  METHODS
  All NPC patients presenting from September 2008 till January 2011 at the ear, nose and throat (ENT) department of the Dr. Sardjito General Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia, were possible candidates. Patients were included if the biopsy was a histological proven NPC without distant metastasis and were assessed during counselling sessions prior to treatment, as being able to complete the entire treatment.
  
  
  RESULTS
  In total 78 patients were included for treatment analysis. The median time between diagnosis and start of radiotherapy is 120 days. Forty-eight (62%) patients eventually finished all fractions of radiotherapy. The median duration of the radiotherapy is 62 days for 66 Gy. Median overall survival is 21 months (95% CI 18-35) from day of diagnosis.
  
  
  CONCLUSIONS
  The results presented here reveal that currently the treatment of NPC at an Indonesian hospital is not sufficient and cannot be compared to the treatment results in literature. Main reasons for these poor treatment results are (1) a long waiting time prior to the start of radiotherapy, (2) the extended overall duration of radiotherapy and (3) the advanced stage of disease at presentation.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Maarten A
authors.initials: MA
authors.lastname: Wildeman
authors.forename: Renske
authors.initials: R
authors.lastname: Fles
authors.forename: Camelia
authors.initials: C
authors.lastname: Herdini
authors.forename: Rai S
authors.initials: RS
authors.lastname: Indrasari
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Vincent
authors.forename: Maesadji
authors.initials: M
authors.lastname: Tjokronagoro
authors.forename: Sharon
authors.initials: S
authors.lastname: Stoker
authors.forename: Johan
authors.initials: J
authors.lastname: Kurnianda
authors.forename: Baris
authors.initials: B
authors.lastname: Karakullukcu
authors.forename: Kartika W
authors.initials: KW
authors.lastname: Taroeno-Hariadi
authors.forename: Olga
authors.initials: O
authors.lastname: Hamming-Vrieze
authors.forename: Jaap M
authors.initials: JM
authors.lastname: Middeldorp
authors.forename: Bambang
authors.initials: B
authors.lastname: Hariwiyanto
authors.forename: Sofia M
authors.initials: SM
authors.lastname: Haryana
authors.forename: I Bing
authors.initials: IB
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma; D005260:Female; D006801:Humans; D007214:Indonesia; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D009367:Neoplasm Staging; D010778:Photochemotherapy; D011379:Prognosis; D011878:Radiotherapy; D016896:Treatment Outcome; D055815:Young Adult