open access

Vol 17, No 2 (2012)
Published online: 2012-03-01
Submitted: 2011-08-19
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Nasopharyngeal carcinoma in Slovenia, 1990–2003 (results of treatment with conventional two-dimensional radiotherapy)

Janka Čarman, Primož Strojan
DOI: 10.1016/j.rpor.2012.01.002
·
Rep Pract Oncol Radiother 2012;17(2):71-78.

open access

Vol 17, No 2 (2012)
Published online: 2012-03-01
Submitted: 2011-08-19

Abstract

Aim

To review the treatment results and identify prognostic factors for disease control and survival in a cohort of nasopharyngeal carcinoma (NPC) patients from a non-endemic population in Slovenia, diagnosed between 1990 and 2003.

Background

In Caucasians, nasopharyngeal carcinoma is a rare malignant tumor. Its diagnosis and treatment are complex and have been dramatically impacted by recent technological advances.

Materials and methods

In the Cancer Registry of Slovenia database, a total of 126 patients with NPC were identified, 93 of whom were available for analysis. All patients were treated with conventional two-dimensional radiotherapy (RT) and 29.3% underwent chemotherapy (ChT).

Results

The median follow-up time for those alive at the last follow-up examination was 74.5 months. Disease recurred locally in 17 patients, regionally in 4 patients and at distant sites in 18 patients, resulting in 5-year locoregional control (LRC), distant failure-free survival (DFFS) and disease-free survival (DFS) of 73.7%, 78.6% and 59.3%, respectively. Disease-specific survival at 5 years was 59% and overall survival (OS) was 49.7%. In a multivariate analysis, LRC was favorably affected (P[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.05) by an undifferentiated histology (hazard ratio [HR][[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]2.86), DFFS through the absence of neck metastases (HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.28), DFS by younger age (HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.46), and more intensive RT (expressed as the isoeffective dose, EQD2,T; HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]2.08). The independent prognosticator for OS was age (≤55 years vs. >55 years, HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.39); in the ≤55 years subgroup, an improved OS was connected to a more intensive RT regimen of EQD2,T[[ce:hsp sp="0.25"/]]≥[[ce:hsp sp="0.25"/]]66[[ce:hsp sp="0.25"/]]Gy (HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]4.17).

Conclusions

Our results confirm an independent and favorable effect from an undifferentiated histology, the absence of neck metastases, a younger patient age at diagnosis, and more intensive RT regimens for disease control and survival.

Abstract

Aim

To review the treatment results and identify prognostic factors for disease control and survival in a cohort of nasopharyngeal carcinoma (NPC) patients from a non-endemic population in Slovenia, diagnosed between 1990 and 2003.

Background

In Caucasians, nasopharyngeal carcinoma is a rare malignant tumor. Its diagnosis and treatment are complex and have been dramatically impacted by recent technological advances.

Materials and methods

In the Cancer Registry of Slovenia database, a total of 126 patients with NPC were identified, 93 of whom were available for analysis. All patients were treated with conventional two-dimensional radiotherapy (RT) and 29.3% underwent chemotherapy (ChT).

Results

The median follow-up time for those alive at the last follow-up examination was 74.5 months. Disease recurred locally in 17 patients, regionally in 4 patients and at distant sites in 18 patients, resulting in 5-year locoregional control (LRC), distant failure-free survival (DFFS) and disease-free survival (DFS) of 73.7%, 78.6% and 59.3%, respectively. Disease-specific survival at 5 years was 59% and overall survival (OS) was 49.7%. In a multivariate analysis, LRC was favorably affected (P[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.05) by an undifferentiated histology (hazard ratio [HR][[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]2.86), DFFS through the absence of neck metastases (HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.28), DFS by younger age (HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.46), and more intensive RT (expressed as the isoeffective dose, EQD2,T; HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]2.08). The independent prognosticator for OS was age (≤55 years vs. >55 years, HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.39); in the ≤55 years subgroup, an improved OS was connected to a more intensive RT regimen of EQD2,T[[ce:hsp sp="0.25"/]]≥[[ce:hsp sp="0.25"/]]66[[ce:hsp sp="0.25"/]]Gy (HR[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]4.17).

Conclusions

Our results confirm an independent and favorable effect from an undifferentiated histology, the absence of neck metastases, a younger patient age at diagnosis, and more intensive RT regimens for disease control and survival.

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Keywords

Nasopharyngeal carcinoma; Radiotherapy; Chemotherapy; Survival; Prognostic factors

About this article
Title

Nasopharyngeal carcinoma in Slovenia, 1990–2003 (results of treatment with conventional two-dimensional radiotherapy)

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 17, No 2 (2012)

Pages

71-78

Published online

2012-03-01

DOI

10.1016/j.rpor.2012.01.002

Bibliographic record

Rep Pract Oncol Radiother 2012;17(2):71-78.

Keywords

Nasopharyngeal carcinoma
Radiotherapy
Chemotherapy
Survival
Prognostic factors

Authors

Janka Čarman
Primož Strojan

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