Assessment of Response to Chemoradiation and Radiation Therapy in Patients with Nasopharyngeal Carcinoma
DOI:
https://doi.org/10.3889/oamjms.2022.10438Keywords:
Nasopharyngeal Carcinoma, Chemoradiotherapy, Head-and-neck cancerAbstract
BACKGROUND: Nasopharyngeal carcinoma (NPC) is a head-and-neck cancer that develops in the epithelial lining of the nasopharynx. The provision of radiotherapy and chemoradiation therapy in NPC can be evaluated by assessing the tumor response.
AIM: The present study aims to determine the response in patients with nasopharyngeal carcinoma (NPC) to radiotherapy and chemoradiation therapy.
METHODOLOGY: The study design is a retrospective bivariate analytic study from the Otorhinolaryngology-Head and Neck Society Head-Neck Surgical Oncology data registry program for the period of 2016−2021 at Dr. Hasan Sadikin General Hospital, Bandung. A total sample of 447 patients with NPC was used, and data were processed with descriptive and bivariate analytical tests. The variables used were patient characteristics and tumor response to radiotherapy and chemoradiation therapy. The tumor response was obtained based on the results of the examination at least 3 months after the administration of therapy and categorized according to the Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1).
RESULTS: Three hundred and eighty-three NPC patients (252 men and 131 women) underwent chemoradiation or radiation therapy, and their tumor response had been evaluated. Most patients were diagnosed at Stages III and IV and treated by chemoradiation. In total, 314 of 383 patients (82%) achieved CR (complete response), 50 patients (13.1%) achieved PR (partial response), 11 patients (2.9%) had PD (progressive disease), and 8 (2.1%) patients had SD (stable disease). There is no statistically significant difference in the type of therapy response when correlated with the each of the variables; age, sex, and educational level (p > 0.05). There is a statistically significant difference in the type of therapy response among different clinical stage groups (p < 0.0001).
CONCLUSION: Most nasopharyngeal carcinoma patients in the study had a complete response (82%) for either chemoradiation or radiotherapy alone. Age, sex, and education level have no significant effect on therapy response. On the other hand, the response to therapy is significantly correlated to the clinical stage of the disease.Downloads
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Mohammed MA, Abd Ghani MK, Hamed RI, Ibrahim DA. Review on nasopharyngeal carcinoma: Concepts, methods of analysis, segmentation, classification, prediction and impact: A review of the research literature. J Comput Sci. 2017;21:283-98. https://doi.org/10.1016/j.jocs.2017.03.021 DOI: https://doi.org/10.1016/j.jocs.2017.03.021
Watkinson JC, Gilbert RW. Stell and Maran’s textbook of head and neck surgery and oncology, 5th edn. Ann R Coll Surg Engl. 2013;95(3):231. https://doi.org/10.1308/rcsann.2013.95.3.231 DOI: https://doi.org/10.1308/rcsann.2013.95.3.231
Simo R, Robinson M, Lei M, Sibtain A, Hickey S. Nasopharyngeal carcinoma: United Kingdom national multidisciplinary guidelines. J Laryngol Otol. 2016;130(S2):S97-103. https://doi.org/10.1017/S0022215116000517 PMid:27841121 DOI: https://doi.org/10.1017/S0022215116000517
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49. https://doi.org/10.3322/caac.21660 PMid:33538338 DOI: https://doi.org/10.3322/caac.21660
Forman D, Bray F, Brewster DH, Mbalawa CG, Kohler B, Piñeros M, et al. Cancer incidence in Five Continents. Vol. 10. Lyon, France: IARC Scientific Publication; 2013. p. 164.
Mahdavifar N, Ghoncheh M, Mohammadian-Hafshejani A, Khosravi B, Salehiniya H. Epidemiology and inequality in the incidence and mortality of nasopharynx cancer in Asia. Osong Public Health Res Perspect. 2016;7(6):360-72. https://doi.org/10.1016/j.phrp.2016.11.002 PMid:28053841 DOI: https://doi.org/10.1016/j.phrp.2016.11.002
Adham M, Kurniawan AN, Muhtadi AI, Roezin A, Hermani B, Gondhowiardjo S, et al. Nasopharyngeal carcinoma in Indonesia: Epidemiology, incidence, signs, and symptoms at presentation. Chin J Cancer. 2012;31(4):185-96. https://doi.org/10.5732/cjc.011.10328 PMid:22313595 DOI: https://doi.org/10.5732/cjc.011.10328
International Agency for Research on Cancer. Global Cancer Statistics 2020. Indonesia: International Agency for Research on Cancer; 2021. Available from: https://gco.iarc.fr/today/data/factsheets/populations/360-indonesia-fact-sheets.pdf [Last accessed on 2021 Jan 30].
Shah JP, Patel SG, Singh B. Jatin Shah’s Head and Neck Surgery and Oncology E-Book. Edinburgh, London: Elsevier Health Sciences; 2012.
Kamran SC, Riaz N, Lee N. Nasopharyngeal carcinoma. Surg Oncol Clin. 2015;24(3):547-61. https://doi.org/10.1016/j.soc.2015.03.008 PMid:25979399 DOI: https://doi.org/10.1016/j.soc.2015.03.008
Nishino M. Tumor response assessment for precision cancer therapy: Response evaluation criteria in solid tumors and beyond. Am Soc Clin Oncol Educ Book. 2018;38:1019-29. https://doi.org/10.1200/EDBK_201441 PMid:30231378 DOI: https://doi.org/10.1200/EDBK_201441
Hardianti RA, Dewi YA, Utami RD. Risk factor of nasopharyngeal carcinoma Dr. Hasan Sadikin general hospital Bandung. Int J Nasopharyngeal Carcinoma. 2019;1(3):110-1. https://doi.org/10.32734/ijnpc.v1i03.2065 DOI: https://doi.org/10.32734/ijnpc.v1i03.2065
Chang ET, Ye W, Zeng YX, Adami HO. The evolving epidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev. 2021;30(6):1035-47. https://doi.org/10.1158/1055-9965.EPI-20-1702 PMid:33849968 DOI: https://doi.org/10.1158/1055-9965.EPI-20-1702
Xie SH, Yu IT, Tse LA, Mang OW, Yue L. Sex difference in the incidence of nasopharyngeal carcinoma in Hong Kong 1983- 2008: Suggestion of a potential protective role of oestrogen. Eur J Cancer. 2013;49(1):150-5. https://doi.org/10.1016/j.ejca.2012.07.004 PMid:22892061 DOI: https://doi.org/10.1016/j.ejca.2012.07.004
Handayani R, Dewi YA, Madani DZ. Prevalence of nasopharyngeal carcinoma patients in departement of ORL-HNS Hasan Sadikin general hospital 2010-2017. Int J Nasopharyngeal Carcinoma. 2020;2(1):1-3. https://doi.org/10.32734/ijnpc.v2i01.3191 DOI: https://doi.org/10.32734/ijnpc.v2i01.3191
Wildeman MA, Fles R, Herdini C, Indrasari RS, Vincent AD, Tjokronagoro M, et al. Primary treatment results of nasopharyngeal carcinoma (NPC) in Yogyakarta, Indonesia. PLoS One. 2013;8(5):e63706. https://doi.org/10.1371/journal.pone.0063706 PMid:23675501 DOI: https://doi.org/10.1371/journal.pone.0063706
Adriana R, Dewi YA, Samiadi D, Candra EW. Survival analysis of nasopharyngeal carcinoma in Hasan Sadikin hospital. Int J Nasopharyngeal Carcinoma. 2019;1(1):3-6. https://doi.org/10.32734/ijnpc.v1i1.952 DOI: https://doi.org/10.32734/ijnpc.v1i1.952
Beyene ET, Ketema SG, Alebachew AN, Saleh MY, Gebremariam TA. Descriptive epidemiology of nasopharyngeal carcinoma at Tikur Anbessa hospital, ethiopia. BMC Cancer. 2021;21(1):540. https://doi.org/10.1186/s12885-021-08311-8 PMid:33980204 DOI: https://doi.org/10.1186/s12885-021-08311-8
Ruback MJ, Galbiatti AL, Arantes LM, Marucci GH, Russo A, Ruiz-Cintra MT, et al. Clinical and epidemiological characteristics of patients in the head and neck surgery department of a university hospital. Sao Paulo Med J. 2012;130(5):307-13. https://doi.org/10.1590/S1516-31802012000500007 PMid:23174870 DOI: https://doi.org/10.1590/S1516-31802012000500007
Bossi P, Chan AT, Licitra L, Trama A, Orlandi E, Hui EP, et al. Nasopharyngeal carcinoma: ESMO-EURACAN clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021;32(4):452-65. https://doi.org/10.1016/j.annonc.2020.12.007 PMid:33358989 DOI: https://doi.org/10.1016/j.annonc.2020.12.007
Sun XS, Liu SL, Luo MJ, Li XY, Chen QY, Guo SS, et al. The association between the development of radiation therapy, image technology, and chemotherapy, and the survival of patients with nasopharyngeal carcinoma: A cohort study from 1990 to 2012. Int J Radiat Oncol Biol Phys. 2019;105(3):581-90. https://doi.org/10.1016/j.ijrobp.2019.06.2549 PMid:31319091 DOI: https://doi.org/10.1016/j.ijrobp.2019.06.2549
Qiu WZ, Huang PY, Shi JL, Xia HQ, Zhao C, Cao KJ. Neoadjuvant chemotherapy plus intensity-modulated radiotherapy versus concurrent chemoradiotherapy plus adjuvant chemotherapy for the treatment of locoregionally advanced nasopharyngeal carcinoma: A retrospective controlled study. Chin J Cancer. 2016;35(1):1-9. https://doi.org/10.1186/s40880-015-0076-9 PMid:26739148 DOI: https://doi.org/10.1186/s40880-015-0076-9
Liang SB, Zhang N, Chen DM, Yang XL, Chen BH, Zhao H, et al. Prognostic value of gross tumor regression and plasma Epstein barr virus DNA levels at the end of intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma. Radiother Oncol. 2019;132:223-9. https://doi.org/10.1016/j.radonc.2018.10.010 PMid:30366725 DOI: https://doi.org/10.1016/j.radonc.2018.10.010
Li WF, Zhang Y, Liu X, Tang LL, Tian L, Guo R, et al. Delayed clinical complete response to intensity-modulated radiotherapy in nasopharyngeal carcinoma. Oral Oncol. 2017;75:120-6. https://doi.org/10.1016/j.oraloncology.2017.10.020 PMid:29224808 DOI: https://doi.org/10.1016/j.oraloncology.2017.10.020
Amin MB, Edge SB, Greene FL. AJCC Cancer Staging Manual. Vol. 8. New York: Springer; 2017. DOI: https://doi.org/10.1007/978-3-319-40618-3
Peng H, Chen L, Li WF, Guo R, Mao YP, Zhang Y, et al. Tumor response to neoadjuvant chemotherapy predicts long-term survival outcomes in patients with locoregionally advanced nasopharyngeal carcinoma: A secondary analysis of a randomized phase 3 clinical trial. Cancer. 2017;123(9):1643-52. https://doi.org/10.1002/cncr.30520 PMid:28001301 DOI: https://doi.org/10.1002/cncr.30520
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Copyright (c) 2022 Sebastian Ario Susanto, Yussy Afriani Dewi, Raden Ayu Hardianti Saputri (Author)
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