Objective: This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in Philippine Oncology Centre Corporation (POCC). Materials and Methods: The patients with NPC referred for treatment at POCC from 2002-2009 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), loco-regional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 106 patients with newly diagnosed NPC were treated in POCC during this period. Late presentation was common, with 19.8% presenting with T3-4 disease, 88.7% with N1-3 disease and 73.5% with AJCC stage 3-4 disease. Radical RT was given to 96 patients with 23.6% having RT alone and 67.4% having CCRT. The stipulated OTT was 7 weeks and 72% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 13.5% while adjuvant chemotherapy was administered to 17%. The 5 years OS was 51.5% with a median follow up of 56 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.9%, respectively. RT related late effects were documented in 71.7%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (18.2%), visual deficit (4.2%), neck stiffness (4.2%), dysphagia (2.3%), cranial nerve palsy (2.4%), pneumonitis (0.9%) and hypothyroidism (1.3%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.

In endemic regions such as southern China and Southeast Asia, the annual incidence of nasopharyngeal carcinoma (NPC) ranges from 3 to 30 per 100,000. In the Philippines, the estimated incidence in 2010 was 1.2 per 100,000. However, this rate is based on data collected from registries covering only two regions in the country. Here, we report the findings from our study to better approximate the incidence of NPC in the Philippines. Between September 1, 2011 and August 31, 2012, data were collected from 49 patients from 4 different institutions-University of Santo Tomas, Makati Medical Center, Philippine Oncology Center Corporation, and Cardinal Santos Memorial Medical Center-using a NPC screening questionnaire. Crude incidence was 0.09 per 100,000. Age-standardized incidences using Segi and WHO standards were 2.08 and 1.79 per 100,000, respectively. Of the 49 patients, 31 were males and 18 were females, and 71% of patients were between 30 and 59 years old. WHO types II and III represented 22% and 78% of the subjects, respectively, and 75.5% of cases were locally advanced (stages III-IVB). Although the age-standardized incidence from the 4 institutions was numerically higher than the published age-standardized incidence (2.07 per 100,000 vs. 1.2 per 100,000), two-proportion z-test showed no significant difference between them (P = 0.68). A more concerted effort is needed for a better approximation of the country's NPC disease burden.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Child ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; epidemiology ; pathology ; Neoplasm Staging ; Philippines ; epidemiology ; Registries ; Surveys and Questionnaires ; Young Adult