title: Radiotherapeutic treatment of a fighter pilot with nasopharyngeal carcinoma.
abstract: BACKGROUND
  Radiotherapy is the standard and most effective treatment for nasopharyngeal carcinoma (NPC) in its early stages. However, its application in fighter pilots returning to flying duties with NPC has not been previously reported, presumably due to post-radiotherapeutic complications.
  
  
  METHODS
  A 36-yr-old male fighter pilot had a painless mass in the left neck for 5 mo. Pathological diagnosis demonstrated nonkeratinizing squamous cell carcinoma in the left nasopharynx which had metastasized to lymph nodes in the left side of the neck. He was diagnosed and staged with NPC (T1N2M0) before treatment with radiotherapy and adjuvant chemotherapy. The patient suffered from catarrhal otitis media and xerostomia after 3 mo of radiotherapy, but these symptoms resolved. After a total of 8 mo of radiotherapy, he was in remission with no evidence of tumor recurrence or metastasis. He had normal Eustachian tube, hearing, and vestibular function before and after hypobaric chamber testing and passed all flight-related physical examinations. Consequently, he was granted a medical waiver and returned to flying status in two-seat fighter aircraft, flying for 53 h in a 12-mo period. After passing all flight-related tests again, he was then allowed to fly in single-seat aircraft. At the time of submission of this article, he has flown for 147 h and remained on flying status for 26 mo. He will be monitored annually for long-term effects of radiotherapy and/or disease recurrence.
  
  
  CONCLUSIONS
  Fighter pilots with NPC may be safely considered for medical waiver with appropriate monitoring after successful treatment.
authors.affiliation: Center of Clinical Aviation Medicine, General Hospital of PLA Air Force, Beijing, China.
authors.forename: Xian-Rong
authors.initials: XR
authors.lastname: Xu
authors.forename: Bin-Ru
authors.initials: BR
authors.lastname: Wang
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhan-Guo
authors.initials: ZG
authors.lastname: Jin
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D002277:Carcinoma; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D009305:Nasopharynx / Q000000981:diagnostic imaging / Q000473:pathology; D009960:Oropharynx / Q000528:radiation effects; D010033:Otitis Media / Q000209:etiology; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D015837:Vestibular Diseases / Q000209:etiology; D014987:Xerostomia / Q000209:etiology