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Nasopharyngeal cancer: an update on diagnosis and treatment

Year 2019, , 1 - 5, 31.03.2019
https://doi.org/10.33204/mucosa.540845

Abstract

Nasopharyngeal carcinoma (NPC) has distinct epidemiological and histological features among head and neck cancers.

Clinical signs in patients with NPC change according to the tumor size and the status of lymph node metastases.

Tumor can expand anteriorly to nasal cavity, pterygoid fossa or maxillary sinus, laterally to parapharyngeal space

and infratemporal fossa, or posterosuperiorly to cranial base, clivus and intracranial structures. Radiotherapy is the

primary treatment in NPC. In tertiary centers, intensity modulated radiotherapy (IMRT) is the preferred radiotherapy

module. Concurrent chemoradiotherapy is the standard treatment of locally advanced NPC. Standard regimen

includes radiation to 70 Gy to the gross tumor in daily fractions of 2 Gy and additional chemotherapy which includes

100 mg/m2 of cisplatin every 3 weeks or 30-40 mg/m2 once a week.

In this article, updated staging in American Joint Committe on Cancer (AJCC) 8th edition guidelines, diagnostic

methods and treatment modalities in NPC are reviewed and presented in the light of current literature.

References

  • References:
  • 1. Wee JT, Ha TC, Loong SL, Qian CN. Is nasopharyngeal cancer really a “Cantonese cancer”? Chin J Cancer 2010;29:517-26.
  • 2. Yu MC. Nasopharyngeal carcinoma: epidemiology and dietary factors. IARC Sci Publ 1991;105:39-47.
  • 3. Henderson BE, Louie E, SooHoo Jing J, Buell P, Gardner MB. Risk factors associated with nasopharyngeal carcinoma. N Engl J Med 1976;295:1101-6.
  • 4. Hyare H, Wisco JJ, Alusi G, et al. The anatomy of nasopharyngeal carcinoma spread through the pharyngobasilar fascia to the trigeminal mandibular nerve on 1.5 T MRI. Surg Radiol Anat 2010;32:937-44.
  • 5. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:359-86.
  • 6. Wei WI, Sham JS. Nasopharyngeal carcinoma. Lancet 2005;365:2041-55.
  • 7. El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ WHO Classification of Head and Neck Tumours, WHO Classification of Tumours, 4th Edition, Volume 9, pp:357-68.
  • 8. Chan AS, To KF, Lo KW, et al. High frequency of chromosome 3p deletion in histologically normal nasopharyngeal epithelia from southern Chinese. Cancer Res 2000;60:5365-70.
  • 9. Tsang CM, Deng W, Yip YL, et al. Epstein-Barr virus infection and persistence in nasopharyngeal epithelial cells. Chin J Cancer 2014;33:549-55.
  • 10. Lin Z, Khong B, Kwok S, et al. Human papillomavirus 16 detected in nasopharyngeal carcinomas in white Americans but not in endemic Southern Chinese patients. Head Neck 2014;36:709-14.
  • 11. Stenmark MH, McHugh JB, Schipper M, et al. Nonendemic HPV-positive nasopharyngeal carcinoma: association with poor prognosis. Int J Radiat Oncol Biol Phys 2014;88:580-8.
  • 12. Maxwell JH, Kumar B, Feng FY, et al. HPV-positive/ p16-positive/EBV-negative nasopharyngeal carcinoma in white North Americans. Head Neck 2010;32:562-7.
  • 13. Chan YH, Lo CM, Lau HY, Lam TH. Vertically transmitted nasopharyngeal infection of the human papillomavirus: does it play an aetiological role in nasopharyngeal cancer? Oral Oncol 2014;50:326-9.
  • 14. Dogan S, Hedberg ML, Ferris RL, et al. Human papillomavirus and Epstein-Barr virus in nasopharyngeal carcinoma in a low-incidence population. Head Neck 2014;36:511-6.
  • 15. Sanguineti G, Geara FB, Garden AS, et al. Carcinoma of the nasopharynx treated by radiotherapy alone: determinants of local and regional control. Int J Radiat Oncol Biol Phys 1997;37:985-96.
  • 16. Kamran SC, Riaz N, Lee N. Nasopharyngeal carcinoma. Surg Oncol Clin N Am 2015;24:547-61.
  • 17. Lydiatt WM, Patel SG, O’Sullivan B, et al. Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin 2017;67:122-37.
  • 18. Chua ML, Ong SC, Wee JT, et al. Comparison of 4 modalities for distant metastasis staging in endemic nasopharyngeal carcinoma. Head Neck 2009;31:346-5.
  • 19. Chang MC, Chen JH, Liang JA, et al. Accuracy of whole-body FDG-PET and FDG-PET/CT in M staging of nasopharyngeal carcinoma: a systematic review and meta-analysis. Eur J Radiol 2013;82:366-73.
  • 20. Xiao WW, Han F, Lu TX, et al. Treatment outcomes after radiotherapy alone for patients with early-stage nasopharyngealcarcinoma. Int J Radiat Oncol Biol Phys 2009;74:1070-6.
  • 21. Chen QY, Wen YF, Guo L, et al. Concurrent chemoradiotherapy vs radiotherapy alone in stage II nasopharyngeal carcinoma: phase III randomized trial. J Natl Cancer Inst 2011;103:1761-70.
  • 22. Tao CJ, Lin L, Zhou GQ, et al. Comparison of longterm survival and toxicity of cisplatin delivered weekly versus every three weeks concurrently with intensity-modulated radiotherapy in nasopharyngeal carcinoma. PLoS One 2014;9:e110765.
  • 23. Le QT, Jones CD, Yau TK, et al. A comparison study of different PCR assays in measuring circulating plasma epstein-barr virus DNAlevels in patients with nasopharyngeal carcinoma. Clin Cancer Res 2005;11:5700-7.
  • 24. Lin JC, Wang WY, Liang WM, et al. Long-term prognostic effects of plasma epstein-barr virus DNA by minor groove binder-probe real-time quantitative PCR on nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy. Int J Radiat Oncol Biol Phys 2007;68:1342-8.
  • 25. Zhang AM, Fan Y, Wang XX, et al. Increased treatment-related mortality with additional cisplatin-based chemotherapy in patients with nasopharyngeal carcinoma treated with standard radiotherapy. Radiother Oncol 2012;104:279-85.
  • 26. Kong L, Zhang Y, Hu C, Guo Y, Lu JJ. Effects of induction docetaxel, platinum, and fluorouracil chemotherapy in patients with stage III or IVA/B nasopharyngeal cancer related with concurrent chemoradiation therapy: Final results of 2 parallel phase 2 clinical trials. Cancer 2017;123:2258-67.
  • 27. Xie P, Yue JB, Zhao HX, et al. Prognostic value of 18F-FDG PET-CT metabolic index for nasopharyngeal carcinoma. J Cancer Res Clin Oncol 2010;136:883-9.
  • 28. Hui EP, Taylor GS, Jia H, et al. Phase I trial of recombinant modified vaccinia ankara encoding Epstein-Barr viral tumor antigens in nasopharyngeal carcinoma patients. Cancer Res 2013;73:1676-88.
  • 29- Taylor GS, Jia H, Harrington K, et al. A recombinant modified vaccinia ankara vaccine encoding Epstein-Barr Virus (EBV) target antigens: a phase I trial in UK patients with EBV-positive cancer. Clin Cancer Res 2014;20:5009-22.
  • 30. Lim WT, Ng QS, Ivy P, et al. A Phase II study of pazopanib in Asian patients with recurrent/metastatic nasopharyngeal carcinoma. Clin Cancer Res 2011;17:5481-9.
  • 31. Hui EP, Ma BBY, Loong HHF, et al. Efficacy, Safety, and Pharmacokinetics of Axitinib in Nasopharyngeal Carcinoma: A Preclinical and Phase II Correlative Study. Clin Cancer Res 2018;24:1030-7.

Nazofarinks kanseri: Tanı ve tedavide güncelleme

Year 2019, , 1 - 5, 31.03.2019
https://doi.org/10.33204/mucosa.540845

Abstract

Nazofarengeal karsinom (NPC), baş boyun kanserleri arasında belirgin epidemiyolojik ve histolojik özelliklere sahiptir.

Hastalarda klinik bulgular, tümör boyutuna ve lenf nodu metastazlarının durumuna göre değişir. Tümör

anteriordan burun boşluğuna, pterygoid fossa veya maksiller sinüse, lateral olarak parafarengeal boşluğa ve infratemporal

fossaya ya da posterosuperiordan kraniyal baz, klivus ve intrakraniyal yapılara yayılabilir. Radyoterapi, primer

tedavidir. İleri merkezlerde yoğunluk modülasyonlu radyoterapi (IMRT) tercih edilen radyoterapi modülüdür. Eş

zamanlı kemoradyoterapi lokal ileri hastalığın standart tedavisidir. Standart rejim, 2 Gy günlük fraksiyonlarda brüt

tümöre 70 Gy radyasyon ve üç haftada bir 100 mg/m2 veya haftada bir 30-40 mg/m2 cisplatin içeren kemoterapinin

eklenmesidir.

Bu makalede, American Joint Committe on Cancer (AJCC) 8. baskı kılavuzlarındaki güncellenmiş evreleme, NPC’deki

tanı yöntemleri ve tedavi yöntemleri literatür ışığında gözden geçirilmiş ve sunulmuştur.

References

  • References:
  • 1. Wee JT, Ha TC, Loong SL, Qian CN. Is nasopharyngeal cancer really a “Cantonese cancer”? Chin J Cancer 2010;29:517-26.
  • 2. Yu MC. Nasopharyngeal carcinoma: epidemiology and dietary factors. IARC Sci Publ 1991;105:39-47.
  • 3. Henderson BE, Louie E, SooHoo Jing J, Buell P, Gardner MB. Risk factors associated with nasopharyngeal carcinoma. N Engl J Med 1976;295:1101-6.
  • 4. Hyare H, Wisco JJ, Alusi G, et al. The anatomy of nasopharyngeal carcinoma spread through the pharyngobasilar fascia to the trigeminal mandibular nerve on 1.5 T MRI. Surg Radiol Anat 2010;32:937-44.
  • 5. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:359-86.
  • 6. Wei WI, Sham JS. Nasopharyngeal carcinoma. Lancet 2005;365:2041-55.
  • 7. El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ WHO Classification of Head and Neck Tumours, WHO Classification of Tumours, 4th Edition, Volume 9, pp:357-68.
  • 8. Chan AS, To KF, Lo KW, et al. High frequency of chromosome 3p deletion in histologically normal nasopharyngeal epithelia from southern Chinese. Cancer Res 2000;60:5365-70.
  • 9. Tsang CM, Deng W, Yip YL, et al. Epstein-Barr virus infection and persistence in nasopharyngeal epithelial cells. Chin J Cancer 2014;33:549-55.
  • 10. Lin Z, Khong B, Kwok S, et al. Human papillomavirus 16 detected in nasopharyngeal carcinomas in white Americans but not in endemic Southern Chinese patients. Head Neck 2014;36:709-14.
  • 11. Stenmark MH, McHugh JB, Schipper M, et al. Nonendemic HPV-positive nasopharyngeal carcinoma: association with poor prognosis. Int J Radiat Oncol Biol Phys 2014;88:580-8.
  • 12. Maxwell JH, Kumar B, Feng FY, et al. HPV-positive/ p16-positive/EBV-negative nasopharyngeal carcinoma in white North Americans. Head Neck 2010;32:562-7.
  • 13. Chan YH, Lo CM, Lau HY, Lam TH. Vertically transmitted nasopharyngeal infection of the human papillomavirus: does it play an aetiological role in nasopharyngeal cancer? Oral Oncol 2014;50:326-9.
  • 14. Dogan S, Hedberg ML, Ferris RL, et al. Human papillomavirus and Epstein-Barr virus in nasopharyngeal carcinoma in a low-incidence population. Head Neck 2014;36:511-6.
  • 15. Sanguineti G, Geara FB, Garden AS, et al. Carcinoma of the nasopharynx treated by radiotherapy alone: determinants of local and regional control. Int J Radiat Oncol Biol Phys 1997;37:985-96.
  • 16. Kamran SC, Riaz N, Lee N. Nasopharyngeal carcinoma. Surg Oncol Clin N Am 2015;24:547-61.
  • 17. Lydiatt WM, Patel SG, O’Sullivan B, et al. Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin 2017;67:122-37.
  • 18. Chua ML, Ong SC, Wee JT, et al. Comparison of 4 modalities for distant metastasis staging in endemic nasopharyngeal carcinoma. Head Neck 2009;31:346-5.
  • 19. Chang MC, Chen JH, Liang JA, et al. Accuracy of whole-body FDG-PET and FDG-PET/CT in M staging of nasopharyngeal carcinoma: a systematic review and meta-analysis. Eur J Radiol 2013;82:366-73.
  • 20. Xiao WW, Han F, Lu TX, et al. Treatment outcomes after radiotherapy alone for patients with early-stage nasopharyngealcarcinoma. Int J Radiat Oncol Biol Phys 2009;74:1070-6.
  • 21. Chen QY, Wen YF, Guo L, et al. Concurrent chemoradiotherapy vs radiotherapy alone in stage II nasopharyngeal carcinoma: phase III randomized trial. J Natl Cancer Inst 2011;103:1761-70.
  • 22. Tao CJ, Lin L, Zhou GQ, et al. Comparison of longterm survival and toxicity of cisplatin delivered weekly versus every three weeks concurrently with intensity-modulated radiotherapy in nasopharyngeal carcinoma. PLoS One 2014;9:e110765.
  • 23. Le QT, Jones CD, Yau TK, et al. A comparison study of different PCR assays in measuring circulating plasma epstein-barr virus DNAlevels in patients with nasopharyngeal carcinoma. Clin Cancer Res 2005;11:5700-7.
  • 24. Lin JC, Wang WY, Liang WM, et al. Long-term prognostic effects of plasma epstein-barr virus DNA by minor groove binder-probe real-time quantitative PCR on nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy. Int J Radiat Oncol Biol Phys 2007;68:1342-8.
  • 25. Zhang AM, Fan Y, Wang XX, et al. Increased treatment-related mortality with additional cisplatin-based chemotherapy in patients with nasopharyngeal carcinoma treated with standard radiotherapy. Radiother Oncol 2012;104:279-85.
  • 26. Kong L, Zhang Y, Hu C, Guo Y, Lu JJ. Effects of induction docetaxel, platinum, and fluorouracil chemotherapy in patients with stage III or IVA/B nasopharyngeal cancer related with concurrent chemoradiation therapy: Final results of 2 parallel phase 2 clinical trials. Cancer 2017;123:2258-67.
  • 27. Xie P, Yue JB, Zhao HX, et al. Prognostic value of 18F-FDG PET-CT metabolic index for nasopharyngeal carcinoma. J Cancer Res Clin Oncol 2010;136:883-9.
  • 28. Hui EP, Taylor GS, Jia H, et al. Phase I trial of recombinant modified vaccinia ankara encoding Epstein-Barr viral tumor antigens in nasopharyngeal carcinoma patients. Cancer Res 2013;73:1676-88.
  • 29- Taylor GS, Jia H, Harrington K, et al. A recombinant modified vaccinia ankara vaccine encoding Epstein-Barr Virus (EBV) target antigens: a phase I trial in UK patients with EBV-positive cancer. Clin Cancer Res 2014;20:5009-22.
  • 30. Lim WT, Ng QS, Ivy P, et al. A Phase II study of pazopanib in Asian patients with recurrent/metastatic nasopharyngeal carcinoma. Clin Cancer Res 2011;17:5481-9.
  • 31. Hui EP, Ma BBY, Loong HHF, et al. Efficacy, Safety, and Pharmacokinetics of Axitinib in Nasopharyngeal Carcinoma: A Preclinical and Phase II Correlative Study. Clin Cancer Res 2018;24:1030-7.
There are 32 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Review Articles
Authors

Bengu Cobanoglu 0000-0003-3701-1697

Selcuk Arslan This is me 0000-0002-4466-6707

Publication Date March 31, 2019
Published in Issue Year 2019

Cite

Vancouver Cobanoglu B, Arslan S. Nasopharyngeal cancer: an update on diagnosis and treatment. Mucosa. 2019;2(1):1-5.