Long-term survival in nasopharyngeal carcinoma

Second malignant tumors after treatment of nasopharyngeal carcinoma: four case reports and literature review

The purpose of this study was to identify the histopathology, location, and latency interval for the development of second malignant tumors (SMT) after successful treatment for nasopharyngeal carcinoma (NPC). Of 55 patients, four developed SMT after successful treatment of NPC in a single institutional series for an incidence of 7%. An additional 31 patients with SMT after treatment for NPC were identified from the literature. At minimum, all patients were treated with radiotherapy to the primary site. The histopathology of SMT included sarcoma (69%), squamous cell carcinoma (17%), adenocarcinoma (6%), meningioma (6%), and lymphoma (3%). SMT occurred at various sites in the head and neck, but most (51%) arose in the sinonasal cavity. For the entire group, the mean latency interval between treatment for NPC and the development of SMT was 11.8 years. These findings indicate that the development of SMT in patients achieving long-term survival after treatment for NPC may be radiation induced. Long-term follow-up for these patients is important to assess for this potentially late complication.

Spindle cell carcinoma of the nasopharynx

A case of spindle cell carcinoma of the nasopharynx is reported and its current management is reviewed. Surgical excision of the nasopharyngeal tumour may be the treatment of choice in some cases.

Malignant tumours of the nasopharynx: retrospective review of 74 cases

Seventy-four patients with histologically confirmed malignant tumours of the nasopharynx were treated by the Departments of ENT and Radiotherapy of the Sint Radboud Academic Hospital, Nijmegen, The Netherlands. Selected prognostic factors were examined. The 5-year overall survival for the malignant epithelial tumours was 35%. The number of patients treated was too small to reach definite conclusions with respect to age and histology as prognostic factors. Staging, however, seems to be of value and it is suggested that the classification proposed in Kyoto, Japan, 1977 be adopted because it offers a better relationship between clinical staging and prognosis. From our data it appeared that treatment failure occurs mainly because of advanced initial tumour stage or distant metastasis; 40% of patients with initial locoregional control died because of distant metastasis. As half of the patients with distant metastasis presented with 'early' tumour stages (T1, T2, T3a), we strongly recommend adding systemic chemotherapy to the primary treatment of nasopharyngeal tumours.