PURPOSE: This study is to evaluate the xerostomia following 3-dimensional conformal radiation therapy (3D CRT) in nasopharynx cancer patients using the xerostomia questionnaire score (XQS). MATERIALS AND METHODS: Questionnaire study was done on 51 patients with nasopharynx cancer who received 3D CRT from Dec. 2000 to Aug. 2005. 3D CRT technique is based on "serial shrinking field" concept by 3 times of computed tomography (CT) simulation. Total target dose to the primary tumor was 72 Gy with 1.8 Gy daily fractions. Xerostomia was assessed with 4-questions XQS, and the associations between XQS and time elapsed after RT, age, sex, stage, concurrent chemotherapy, and parotid dose were analyzed. RESULTS: Concurrent chemotherapy was given to 40 patients and RT alone was given to 11 patients. The median time elapsed after 3D CRT was 20 (1~58) months and the mean XQS of all 51 patients was 8.4+/-1.9 (6~14). XQS continuously and significantly decreased over time after 3D CRT (x(2)=-0.484, p<0.05). There was no significant difference in XQS according to sex, age, and stag. However, XQS of concurrent chemotherapy patients was significantly higher than RT alone patients (p=0.001). XQS of patients receiving total mean parotid dose > or=35 Gy was significantly higher than <35 Gy (p=0.05). CONCLUSION: Decreasing tendency of XQS over time after 3D CRT was observed. Concurrent chemotherapy and total mean parotid dose > or=35 Gy were suggested to adversely affect radiation-induced xerostomia.
Drug Therapy ; Humans ; Nasopharyngeal Neoplasms* ; Surveys and Questionnaires ; Radiotherapy, Conformal* ; Xerostomia*

We reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach. Case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma. The tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary. The two patients were followed up for 26 and 18 months respectively, and no recurrence was noted without postoperative chemotherapy or radiotherapy. To the best of our knowledge, this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma. Our experience revealed that not only for the early recurrent nasopharyngeal carcinoma, the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma.
Adenocarcinoma* ; Drug Therapy ; Endoscopes ; Humans ; Nasopharyngeal Neoplasms ; Radiotherapy ; Recurrence

PURPOSE: To evaluate the relationship between treatment failure and COX-2 expression in nasopharyngeal cancer patients treated with chemotherapy and radiotherapy. MATERIALS AND METHODS: The subjects of this study were 22 nasopharyngeal cancer patients. The patients were treated with neoadjuvant chemotherapy, followed by radiotherapy, or with radiotherapy alone. The formalin- fixed, paraffin- embedded tissues of 11 patients who developed a locoregional recurrence (n=7) or distant metastasis (n=4) were compared with those of 11 disease free patients. Prognostic factors, including histological type, stage, radiation dose and chemotherapy, were well balanced between the two groups. The COX-2 expression was determined immunohistochemically. RESULTS: COX-2 expression was stronger in the patients with a locoregional recurrence or distant metastasis than in those free of disease. The COX-2 distribution scores of the control group were as follows: 0 in 7, 1 in 2 and 2 in 2 patients. In the recurrence group, the scores were as follows; 0 in 3, 1 in 1, 2 in 2 and 3 in 5 patients. COX-2 expression was shown to have a statistically significant influence on the treatment failure by the Mann-Whitney U test (p=0.024) and Mantel-Haenszel Chi-Square test (p=0.018). It also significantly influenced the treatment failure when an analysis was performed within patients with a undifferentiated histology (p=0.039 by the Mann- Whitney U test, p=0.037 by the Mantel-Haenszel Chi- Square test). CONCLUSION: COX-2 expression is believed to be one of the important factors associated with a locoregional recurrence or distant metastasis.
Cyclooxygenase 2 ; Drug Therapy ; Humans ; Nasopharyngeal Neoplasms* ; Neoplasm Metastasis ; Prostaglandin-Endoperoxide Synthases* ; Radiotherapy ; Recurrence ; Treatment Failure

Thirty-one patients with previously untreated and locally advanced nasopharyngeal caner were retrospectively reviewed for comparing the effects of radical radiotherapy alone with that of combining chemotherapy and radiotherapy from 1983 to 1989 at Kangnam St. Mary's Hospital. 23/31 were evaluable for recurrence and survival. There were 8 patients for stageIII , and 15 patients for stageIV. Eleven patients were treated with radical radiation therapy alone (am I). Twelve patients were given 1~3 courses of cisplatin-5FU or cisplatin-bleomycin-vincristine prior to radiation therapy (am II). The two arms were comparable in patients characteristics of 11 radiotherapy patients, complete response was 55% (6/11) and partial response 45% (5/11). Among 12 patients after induction chemotherapy, complete response was 25% (3/12) and partial response 75% (9/12). After subsequent radiotherapy, complete response was increased to 83% (10/12) and partial response was 17% (2/12). Treatment failure was 36% (local recurrence; 3/11, and regional recurrence; 1/11) in arm l and 33% (local recurrence; 1/12, regional recurrence; 2/12 and distant metastasis; 1/12) in arm II. There was no significant difference in survival between am I and arm II (p>.05). The toxicities of treatment were acceptable. More controlled clinical trails must be completed before acceptance of chemotherapy as part of a standard radical treatment for locally advanced nasopharyngeal cancer.
Arm ; Drug Therapy ; Humans ; Induction Chemotherapy ; Nasopharyngeal Neoplasms ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Treatment Failure

OBJECTIVE: To analyze the nutritional status and nosocomial infection of nasopharyngeal carcinoma patients before and after the chemoradiotherapy treatment. METHOD: An analysis was made for the nutritional and nosocomial infection status of 82 cases before and after chemoradiotherapy treatment. RESULT: Statistically significant differences were revealed between indexes related with nutritional status such as body mass, hemoglobin, serum albumin before and after the treatment. Sixty-three patients occurred nosocomial infection. The infection rate was 76.83%. The main risk factor was oropharynx mucosal lesion and the rate is 92.68%. Isolates of 39 bacteria were found, of which Gram-negative organisms were 58.97%, Fungi were 30.77%, Gram-positive ones were 7.69%, Herpes zoster were 2.56%. CONCLUSION Chemoradiotherapy has negative influence on nutritional status of patients. Medical personnel should pay attention to patients' nutritional status and do a good job of nutritional status monitoring, nutrition support, dieting guidance, reducing side effects, in order to improve the patient's tolerability and quality of life. The nosocomial infection rate of Gram-negative bacteria of oropharyngeal mucosal is the highest in patients with advanced nasopharyngeal cancer during chemoradiotherapy. It is very important for us to prevent and control nosocomial infection.
Adult ; Aged ; Carcinoma ; Combined Modality Therapy ; Cross Infection ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; microbiology ; radiotherapy ; Nutritional Status ; Risk Factors

OBJECTIVE: To analyze the correlation of the tympanic injection of triamcinolone acetonide, middle ear pressure (MEP) and radioactive secretory otitis media (RSOM) with nasopharyngeal carcinoma (NPC) after radiotherapy. METHOD: Fifty-two patients suffering NPC without otitis media before radiotherapy were randomly divided into three groups. 17 cases with 34 ears were distributed into treatment group I, and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-7 weeks 1 times a week. Treatment group I had 17 cases with 34 ears,and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-12 weeks 1 times a week. And control group consisted of 18 cases with 36 ears who didn't accept such treatment. In all 104 ears, MEP was tested at the begin of radiotherapy and the end of 1st, 2nd, 3rd month after radiotherapy. RESULT: From the beginning of radiotherapy to the end of th 1st, 2nd, 3rd month after radiotherapy, the morbidity of RSOM gradually increased and MEP decreased in the treatment group I , II and the control group, in which treatment group II showed the lowest morbidity of RSOM and MEP was maximum (P < 0.01), and the treatment group I showed the lower morbidity of RSOM and MEP was greater (P < 0. 05), while the control group showed the highest morbidity of RSOM and MEP was minimum (P > 0.05). CONCLUSION Tympanic injection of triamcinolone acetonide could reduce radiation injury, and medication time was positively correlated with the MEP, and a negative correlation with RSOM morbidity, and the longer treatment, the more significant the effect is. The difference is most obvious at the end of 3rd month after radiotherapy. It may be due to the more active repairation after radiation damage in middle ears, but long-term efficacy must continue to observe.
Anti-Inflammatory Agents ; administration & dosage ; Carcinoma ; Ear, Middle ; Humans ; Injections ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Otitis Media with Effusion ; drug therapy ; Radiation Injuries ; Triamcinolone Acetonide ; administration & dosage

Radiotherapy is the primary treatment for nasopharyngeal carcinoma, and the disease control rate and survival time are able to be greatly improved by enhancing the radiosensitivity. Via mechanisms such as binding to target genes mRNA 3'untranslated region (3'UTR), microRNA (miRNA) inhibits translation, which therefore regulates transcription of target genes and thus affect target protein expression. Recent research showed that miRNAs play significant roles in improvement of radiosensitivity in nasopharyngeal carcinoma. This article reviews mechanism of miRNA action to strengthen radiosensitivity of nasopharyngeal carcinoma and the future of clinical practice of miRNA in this disease.
3' Untranslated Regions ; Carcinoma ; Humans ; MicroRNAs ; pharmacology ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; RNA, Messenger ; Radiation Tolerance ; Radiation-Sensitizing Agents

NPC is a high incidence of malignant tumors of the head and neck, and is currently used mainly radiotherapy based, supplemented by a comprehensive treatment of chemotherapy, radiotherapy and chemotherapy, which have serious complications and serious impact on the treatment of patients and quality of life. Polyphenols are the main component of tea. Studies have shown that tea polyphenols have a significant anti-tumor effect of im proving the effect of radiotherapy and chemotherapy, reducing radiation damage, reducing conventional chemo therapy drugs IC50 and reducing the complications of chemotherapy. Tea polyphenols in the treatment of nasopharyngeal carcinoma has also made great progress. It has a strong inhibition of nasopharyngeal carcinoma cells, and can greatly reduce the occurrence of xerostomia after radiotherapy, which is of important clinical research value.
Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Carcinoma ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Polyphenols ; pharmacology ; therapeutic use ; Radiation-Protective Agents ; pharmacology ; Tea ; chemistry

From 1984 to 1988, fourt two patients with nasopharyngeal cancer were treated at the Department of Radiation Oncology in Kyungpook National University Hospital. Thirteen patients refused treatment and the median survival time was 7.8 months. Twenty nine patients received a full course of radiation at least 70 gy to the primary site and 60 gy to the nodal sites. These patients were all belonged to stage III or IV. The local control rate was 75% in squamous cell carcinomas, and all the patients with lymphoepithelioma showed a complete response. Overall locoregional failure was 27.6%. Distant metastasis was the predominant pattern of failures; 4/6 in lymphoepithelioma, 4/10 in squamous cell carcinoma. The Three-year-survival rate for squamous cell carcinoma was 40.5%, and for lymphoepithelioma 25.9%, respectively. This may be due to the more frequent distant metastases in lymphoepithelioma and ineffective chemotherapy. No survival correlation was found with the level of neck node involvement. Though adjuvant chemotherapy was found to be of no benefit in overall survival, more prudent and aggressive chemotherapy would be necessary.
Carcinoma, Squamous Cell ; Chemotherapy, Adjuvant ; Drug Therapy ; Gyeongsangbuk-do ; Humans ; Nasopharyngeal Neoplasms* ; Neck ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy

Antineoplastic Agents ; therapeutic use ; Chemotherapy, Adjuvant ; Clinical Trials as Topic ; Humans ; Nasopharyngeal Neoplasms ; drug therapy ; mortality ; radiotherapy ; therapy ; Radiotherapy, Intensity-Modulated ; Research Design ; Singapore