Small cancers of the nasopharynx are highly curable by radiation therapy and have shown
survival rates of 80% to 90%.
Moderately advanced lesions without clinical evidence of spread to cervical
lymph nodes are often curable and have shown survival rates of 50% to 70%.
Patients with advanced lesions, especially those associated with clinically
positive cervical lymph nodes, cranial nerve involvement, and bone destruction,
are poorly controlled locally by radiation therapy with or without surgery and
often develop distant metastases despite local control.[9,10]
Although most recurrences occur within 5 years of diagnosis, relapse can be
seen at longer intervals. The incidence of second primary malignancies appears
less than other head and neck sites.
Follow-up for patients includes routine periodic examination of the original
tumor site and neck, chest x-ray, MRI or CT scan, and blood work. Positron emission tomography scans may be useful in planning treatment for patients with suspected recurrence. Monitoring
of patients should include surveillance of thyroid and pituitary function;
dental and oral hygiene; jaw exercises to avoid trismus; evaluation of cranial
nerve function, especially those related to vision and hearing; and evaluation
of systemic complaints to identify distant metastasis.
Poorly differentiated squamous cancer has been associated with EBV
antibodies.[3,13] High-titer antibodies to virus capsid antigen and early
antigen, especially of high IgA class, or high titers that persist after
therapy, have been associated with a poorer prognosis. This finding remains
- Chien YC, Chen JY, Liu MY, et al.: Serologic markers of Epstein-Barr virus infection and nasopharyngeal carcinoma in Taiwanese men. N Engl J Med 345 (26): 1877-82, 2001.
- Decker J, Goldstein JC: Risk factors in head and neck cancer. N Engl J Med 306 (19): 1151-5, 1982.
- Feinmesser R, Miyazaki I, Cheung R, et al.: Diagnosis of nasopharyngeal carcinoma by DNA amplification of tissue obtained by fine-needle aspiration. N Engl J Med 326 (1): 17-21, 1992.
- Mendenhall WM, Riggs CE Jr, Cassisi NJ: Treatment of head and neck cancers. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2005, pp 662-732.
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- Cummings CW, Fredrickson JM, Harker LA, et al.: Otolaryngology - Head and Neck Surgery. Saint Louis, Mo: Mosby-Year Book, Inc., 1998.
- Sanguineti G, Geara FB, Garden AS, et al.: Carcinoma of the nasopharynx treated by radiotherapy alone: determinants of local and regional control. Int J Radiat Oncol Biol Phys 37 (5): 985-96, 1997.
- Bailet JW, Mark RJ, Abemayor E, et al.: Nasopharyngeal carcinoma: treatment results with primary radiation therapy. Laryngoscope 102 (9): 965-72, 1992.
- Fandi A, Altun M, Azli N, et al.: Nasopharyngeal cancer: epidemiology, staging, and treatment. Semin Oncol 21 (3): 382-97, 1994.
- Teo PM, Chan AT, Lee WY, et al.: Enhancement of local control in locally advanced node-positive nasopharyngeal carcinoma by adjunctive chemotherapy. Int J Radiat Oncol Biol Phys 43 (2): 261-71, 1999.
- Cooper JS, Scott C, Marcial V, et al.: The relationship of nasopharyngeal carcinomas and second independent malignancies based on the Radiation Therapy Oncology Group experience. Cancer 67 (6): 1673-7, 1991.
- Zheng XK, Chen LH, Wang QS, et al.: Influence of [18F] fluorodeoxyglucose positron emission tomography on salvage treatment decision making for locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 65 (4): 1020-5, 2006.
- Neel HB 3rd, Pearson GR, Taylor WF: Antibodies to Epstein-Barr virus in patients with nasopharyngeal carcinoma and in comparison groups. Ann Otol Rhinol Laryngol 93 (5 Pt 1): 477-82, 1984 Sep-Oct.
- Lin JC, Chen KY, Wang WY, et al.: Detection of Epstein-Barr virus DNA the peripheral-blood cells of patients with nasopharyngeal carcinoma: relationship to distant metastasis and survival. J Clin Oncol 19 (10): 2607-15, 2001.