Nasopharyngeal cancer is generally difficult to diagnose at an early stage because it is anatomically hard to access, often asymptomatic, and apt to metastasize. We retrospectively analyzed the date of 19 freshly diagnosed cases of nasopharyngeal cancer who were treated at our department between 2001 and 2013. The patients consisted of 15 males and 4 females, and ranged in age from 17 to 77 years, with an average of 62.6 years.
Our treatment protocol was as follows: For stage I/II cancers: hyperfractionated radiotherapy (1.2 Gy×2/day) to a total of 72 Gy, with concurrent daily carboplatin (25 mg/m2); for stage III/IV cancers: 1–2 courses of induction chemotherapy (docetaxel 60 mg/m2 (day 1), cisplatin 60 mg/m2 (day 1), and 5-fluorouracil 600 mg/m2 (days 1–5)), followed by concurrent chemoradiotherapy as for the stage I/II cancers. Patients with remnant primary tumor received additional radiotherapy with a cyberknife. Patients with remnant disease in the cervical lymph nodes underwent neck dissection if/when they showed complete response of the primary tumor without distant metastasis.
The subdivision of the primary tumor was the posterosuperior wall in 11 patients (58%) and lateral wall in 8 patients (42%). Two patients had stage I disease, 3 patients had stage II disease, 6 patients had stage III disease, and 8 had stage IV disease. The overall 5-year crude and disease-specific survival rates determined by the Kaplan-Meier method were 49.8% and 69.2%, respectively. The 5-year crude and disease-specific survival rates in each stage were 100%/100% (crude/disease-specific) in patients with stage I disease, 33.3%/50.0% in patients with stage II disease, 50.0%/100% in patients with stage III disease, and 31.3%/46.9% in patients with stage IV disease.
The survival rate could be improved by early detection of cancers and altering the treatment protocol for advanced cancers.
