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.

Purpose: To evaluate the use of signal intensity index (SII) of skull-base invasion in nasopharyngeal carcinoma (NPC) using magnetic resonance imaging (MRI), select a best cut-off SII value to predict the outcome of NPC. Materials and Methods: One hundred and twenty-two NPC patients (92 men, 30 women) with skull-base invasion were included. All patients underwent MRI, signal intensities on T1-weighted imaging (T1WI) were measured for each invaded site and its contralateral normal counterpart. The SIIs were calculated, receiver operating characteristic curves were constructed. The optimal cut-off values were extracted. The overall survival (OS) rates of 5-year follow-up were performed. Results: Sensitivities for differentiating skull-base invasion from normal contralateral anatomy were 98.9%, 88.5% and 70.0%, and specificities were 98.9%, 96.0% and 74.4%, respectively. There were three cut-off values for differentiating invasion from normal anatomy of skull-base, 49%, 98%, and 60%. Significant difference in OS rates (84.2% vs. 57.1%, p=0.007) was seen for SII threshold values > 60% and those ≤ 60%. Conclusions: The SII might be a useful means of differentiating invasion from normal tissue at the skull-base in NPC. The cut-off value of quantitative SII at the skull-base may aid in monitoring the response to treatment of NPC patients.

Introduction and objective: Nasopharyngeal carcinomas differ from other head and neck tumors. Patients have a higher rate of survival and thereby have a higher chance of presenting late toxicity, affecting their quality of life. We have tried to evaluate the most relevant late toxicities. Material and methods: We conducted a retrospective analysis in a series of 58 patients diagnosed with nasopharyngeal carcinoma between 1987 and 2014. The non-epithelial histological types were excluded from the study. We analyzed late toxicity and survival using SPSS version 19. Results: We included 58 patients, 93,1% of whom presented locally advanced disease at the time of diagnosis. The predominant subtype was found to be undifferentiated carcinoma. The treatment response rate was 91,2% (75,4% complete response and 15,8% partial response). The relapse rate was 35,1% (35% local relapse and 65% systemic relapse). The median disease-free survival was 150 months and the mean global survival was 224 months (168-279). Conclusions:Nasopharyngeal carcinoma is usually diagnosed in a locally advanced stage. Treatment is based on the use of chemotherapy and radiotherapy, obtaining a high response rate. Currently, there is large group of survivors, whose quality of life is severely affected by late toxicity.

Purpose: To evaluate the feasibility and efficiency of concurrent chemo-radiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients. Patients and Methods: We reviewed data of 33 non-metastatic NPC patients who had been treated with CCRT between January 2004 and December 2006. The Median age of patients was 41 year-old and the male/female ratio was 3. According to the 2002 TNM staging system, T3-T4 locally advanced tumors and N2-N3 nodal status rates were 67% and 46%, respectively. All patients had undifferentiated carcinoma and received conventional fractionated 2D conventional radiotherapy (RT) with a total dose of 70-74 Gy and concurrent weekly intravenous cisplatin (40 mg/m2). Results: The acute toxicities were all manageable. Grade 3-4 mucositis and skin reaction were seen in 6 patients (18%). RT interruption for a week occurred in 1 patient because of a Grade 3 dysphagia. All patients finished their planned RT. Four patients (12%) refused to complete the concurrent chemotherapy (CT) and 5 other patients (15%) did not receive the planned cycles of CT because of renal and/or hematologic toxicities. After a median follow-up of 58 months, 6 patients (18%) developed loco-regional relapse associated with distant metastasis in 4 cases (12%), and 6 patients (18%) developed distant metastases alone. Five-year overall survival and disease-free survival rates were 70 and 63%, respectively. A univariate analysis for prognostic factors was also performed. Overall survive was affected by Stage T4, Stage N3, age >40 years, and cycles of CT ≤ 5. Patients who received more than 5 cycles of cisplatin had also significantly better disease free survival and metastasis free survival. Conclusion: The results of our study have shown that CCRT for locoregionally advanced NPC is both feasible and effective, with acceptable toxic effects. On univariate analysis, the age >40 years, Stage T4, Stage N3, and cycles of CT ≤ 5 had a significantly poor outcome.

We report an unusual case of marked granulomatous reaction developed both before diagnosis and after therapy in a patient with Undifferentiated Nasopharyngeal Carcinoma (UNPC).

Objective: To understand the development of nasopharyngeal carcinoma researches in worldwide, and to study the development feasibility of professional journal on nasopharyngeal carcinoma.Methods: The literatures on nasopharyngeal carcinoma were systematically retrieved from databases of SCI (Science Citation Index) from 1999 to 2012, and the data of publishing time, journal title, article type, language, research area, first author, correspondence author, district, and fund, etc were collected and bibliometricly analyzed.Results: An increasing trend of paper publication was detected, corresponding with linear and exponential growth pattern. Journal distribution was accordance with Brad Ford’s law; the literatures of nasopharyngeal carcinoma were assembling and parting distribution. The first author distribution conformed to Lotka’s law; whereas, the correspondence author distribution did not. Mainland China, Hong Kong and Taiwan occupied an important position in respect of first author, correspondence author and fund.Conclusion: Nasopharyngeal carcinoma study needs professional journals bearing a larger number of scientific research achievements, and journals run in China, where the Nasopharyngeal carcinoma incidences was reported the highest in the world, may promote the development of this subject.