Nasopharyngeal carcinoma: Long term follow-up of 83 patients

作     者：Ali Mardassi Nabil Mathlouthi Nawel Hlila Chiraz Halouani Sameh Mezri Cyrine Zgolli Ghassen Chebbi Rania Ben Mhamed Khemaies Akkari Sonia Benzarti 

作者机构：ENT Department Military Hospital of Tunis 

出 版 物：《World Journal of Otorhinolaryngology》 (世界耳鼻咽喉科杂志)

年 卷 期：2015年第5卷第2期

页      面：65-70页

学科分类：1002[医学-临床医学] 100213[医学-耳鼻咽喉科学] 10[医学] 

主　　题：Nasopharyngeal carcinoma Cranial nerve Radiotherapy Chemotherapy Metastasis 

摘      要：AIM: To analyzes the clinical, paraclinical, therapeutical and evolutive features of nasopharyngeal carcinoma(NPC).METHODS: All the patients treated for a nasopharyngeal carcinoma between 2000 and 2013 in the Ear-NoseThroat Department of the Military Hospital of Tunis, Tunisia were collected in this study. Eighty-three patients signed a written consent prior to study enrollment. The gender ratio(M/W) was 6.5 with a median age of 49 years(range 16-85). The median follow up time was 37 mo(18 to 108 mo). The evolution, during and after the end of therapy, was assessed on clinical biological and radiological exams. Different parameters were analyzed and compared to other series: complications of chemo and radiotherapy, recurrence of the disease, metastasis and overall survival ***: Of the 83 patients of our study, 15% had T1 tumors, 20% had T2, 23% had T3 and 41% had T4 disease. At the time of diagnosis, 14% of the patients had a cranial nerve deficit. Only 12 patients had exclusive radiotherapy and the remaining of our patients had concomitant radio chemotherapy. Iatrogenic complications were diagnosed in 53% of the cases: radioepithelitis(28%), radiodermatitis(9%), xerostomia(17%), osteoradionecrosis(3%), cerebral radionecrosis(1%) and a pancytopenia(17%). The follow-up period varied from 18 to 108 mo(average: 37 mo). During the first six months after treatment, a persistence of the disease was found in 11% of patients, while a recurrence of the cancer was diagnosed in 6% and distant metastasis developed in 14% of the patients. Fifteen patients needed remedial chemotherapy for a relapse or metastasis and five had palliative chemotherapy for very advanced cases. We report 3 cases of death during the follow-up. CONCLUSION: Despite its excellent radio-chemotherapy response, and general good prognosis, a careful follow-up of patients with NPC is necessary to detect and manage any iatrogenic complication, locoregional recurrence or metastasis of the disease.