Treatment Outcomes of Nasopharyngeal Cancer in Faculty of Medicine Vajira Hospital

Abstract

Objective: To evaluate the treatment outcomes in terms of 5-year disease free survival (DFS) and overall survival(OS) in nasopharyngeal cancer. Prognostic factors of treatment were also assessed.

Method: This was a retrospective descriptive study in nasopharyngeal cancer patients who were treated at Radiationoncology unit, Faculty of Medicine Vajira Hospital between January 2004 and December 2009. Medical recordsof the patients including radiation oncology records, out-patient charts and computerized database of theinstitution were reviewed. Patients’ age, tumor’s histologic type, tumor’s stage, type of radiation therapyreceived, complications and results of treatment were recorded.

Results: Mean age of the 81 patients was 45.9 ± 15.2 years. There were 54 male (66.7%) and 27 female (33.3%).The most common histopathology was non-keratinizing undifferentiated carcinoma (98.9%). Patients wereclassified as stage I in 7.4%, stage II in 28.4%, stage III in 17.3% and stage IVA-IVB in 46.9%. Almost allpatients were treated with combination of radiation therapy and chemotherapy (87.7%). The median followuptime of patients was 4 years 8 months (range 1 year 11 months - 7 years 11 months). The 5-year diseasefree survival (DFS) and overall survival (OS) rates for all patients were 57.5% and 69.4%, respectively. Thesignificant prognostic factors associated with survival from multivariable analysis were tumor stage andpretreatment Eastern Cooperative Oncology Group performance status (PS ECOG). Five-year DFS of patientsin early stage (stage I-II) and locally advanced stage (stage III-IVB) were 75.8% and 47.8% (p = 0.047) withthe corresponding 5-year OS of 87.4% and 59.9% (p = 0.018) respectively. Patients with PS ECOG 1 had 5-year DFS of 62.1% compared with 34.3% in patients with PS ECOG 2 (p < 0.001), and 5-year OS were 76.2%and 40.6% respectively (p < 0.001).

Conclusion: The 5-year DFS and OS rates of patients with nasopharyngeal cancer were 57.5% and 69.4% respectively.Tumor stage and pretreatment ECOG PS were the significant prognostic factors for survival.