title: Prolonged complete remission after induction chemotherapy followed by chemoradiation with tomotherapy in metastatic nasopharyngeal cancer.
abstract: BACKGROUND
  Nasopharyngeal carcinoma (NPC) is uncommon in the Western hemisphere and in Europe. The undifferentiated subtype has a relevant propensity to metastasize systemically, mostly in the skeleton. In patients with distant metastasis at presentation there is no consensus on the most appropriate approach.
  
  
  METHODS
  Evaluation of a young patient with initially bony metastatic nasopharyngeal cancer treated with platinum-based induction chemotherapy followed by radiotherapy (performed with Tomotherapy) combined to chemotherapy on primary region with curative intent, and subsequent focal irradiation of the bone metastasis.
  
  
  CONCLUSIONS
  After 27 months from the end of the planned treatment the patient has not shown any late toxicity or complications in the treated areas and is without any evidence of progression. It seems appropriate to treat selected metastatic patients with a radical intent, using induction chemotherapy followed by radical chemoradiotherapy on the primary region and high dose radiation on the metastasis. Moreover, Tomotherapy demonstrated a tolerable grade of acute toxicity without any relevant late complications.
authors.affiliation: Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy didation@hotmail.it.
authors.forename: Dario
authors.initials: D
authors.lastname: Agnese
authors.affiliation: Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Belgioia
authors.affiliation: Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy.
authors.forename: Almalina
authors.initials: A
authors.lastname: Bacigalupo
authors.affiliation: Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Marcenaro
authors.affiliation: Division of Medical Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Vecchio
authors.affiliation: Division of Medical Physics, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Agostinelli
authors.affiliation: Division of Nuclear Medicine, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Morbelli
authors.affiliation: Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Corvò
mesh_terms: D002277:Carcinoma; D059248:Chemoradiotherapy; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D009362:Neoplasm Metastasis; D050397:Radiotherapy, Intensity-Modulated; D016896:Treatment Outcome; D055815:Young Adult
keywords: Nasopharyngeal cancer; chemoradiation; synchronous metastasis; tomotherapy