title: Nasopharyngeal carcinoma: 30-year experience of a single institution in a non-endemic area.
abstract: OBJECTIVE
  Over the past years, radiotherapy techniques have changed significantly. The impact of these changes in the management of nasopharyngeal carcinoma (NPC) has not been fully evaluated.
  
  
  METHODS
  Between 1984 and 2014, 223 NPC were diagnosed in our hospital. Prior to 2000, patients were treated with 2D treatment plan (RT2D) that evolved to 3D schemes thereafter (RT3D).
  
  
  RESULTS
  Tumors in the RT3D period showed significantly lower stages than those in the RT2D period. 5-year cause-specific survival improved from 55.7% (95% CI: 46.7-64.7%) in the RT2D period to 78.7% (95% CI: 68.7-88.7%) in the RT3D period (P = 0.006). This difference was greater for non-keratinizing NPC, where specific survival went from 63.2% (95% CI: 52.2-74.2%) to 84.4% (95% CI: 74.4-94.4%) (P = 0.014).
  
  
  CONCLUSIONS
  Recent changes in treatment strategies including concurrent chemoradiation and 3D radiotherapy may have impacted in better survival for NPC. Improved imaging techniques may have contributed by earlier detection and better treatment planning.
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu I Sant Pau, C. Sant Antoni Maria Claret 167, 08025, Barcelona, Spain. jgarcial@santpau.cat.
authors.forename: J
authors.identifier: http://orcid.org/0000-0002-6123-7808
authors.initials: J
authors.lastname: García-Lorenzo
authors.affiliation: Radiation Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Farre
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu I Sant Pau, C. Sant Antoni Maria Claret 167, 08025, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Codina
authors.affiliation: Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Gallego
authors.affiliation: Radiation Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: De Vega
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu I Sant Pau, C. Sant Antoni Maria Claret 167, 08025, Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: León
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000379:methods / Q000639:trends; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016016:Proportional Hazards Models; D011878:Radiotherapy / Q000379:methods* / Q000639:trends; D013030:Spain; D016896:Treatment Outcome
keywords: Chemoradiation; Chemotherapy; IMRT; Nasopharyngeal carcinoma; Radiation therapy