Clin Exp Otorhinolaryngol.  2010 Mar;3(1):1-12.

Current Management Strategy of Nasopharyngeal Carcinoma

Affiliations
  • 1Department of Surgery, Queen Mary Hospital, University of Hong Kong Medical Centre, Hong Kong SAR, China. hrmswwi@hkucc.hku.hk
  • 2Department of Clinical Oncology, Queen Mary Hospital, University of Hong Kong Medical Centre, Hong Kong SAR, China.

Abstract

Nasopharyngeal carcinoma is an unique head and neck cancer. It is common among the southern Chinese and is closely associated with the Epstein Barr virus (EBV). To diagnose the disease in its early stage is infrequent as the symptoms are usually trivial and patients only present in late stages. Testing the blood for elevated EBV DNA has now become a screening test for the high risk group of patients, aiming to diagnose the disease in its early stages. Imaging studies, positron emission tomography scans in addition to clinical examination provide information on the extent of the disease. The confirmation of the disease still depends on endoscopic examination and biopsy. Radiotherapy with or without chemotherapy has been the primary treatment modality. The application of intensity modulated radiotherapy and the use of concomitant chemoradiation have improved the control of nasopharyngeal carcinoma together with the reduction of long term side effects. The early detection of residual or recurrence tumor in the neck or at the primary site has allowed delivery of salvage treatment. The choice of the optimal surgical salvage, either for neck disease or primary tumor depends on the extent of the residual or recurrent disease. The outcome of these patients have improved with the application of the appropriate surgical salvage.

Keyword

Nasopharyngeal carcinoma; Diagnosis; Management; Radiotherapy; Chemotherapy; Surgical salvage

MeSH Terms

Asian Continental Ancestry Group
Biopsy
DNA
Head and Neck Neoplasms
Herpesvirus 4, Human
Humans
Mass Screening
Nasopharyngeal Neoplasms
Neck
Positron-Emission Tomography
Recurrence
DNA
Nasopharyngeal Neoplasms

Reference

1. Jackson C. Primary carcinoma of the nasopharynx: a table of cases. J Am Med Assoc. 1901; 8. 10. 37(6):371–377.
Article
2. Digby KH, Fook WL, Che YT. Nasopharyngeal carcinoma. Br J Surg. 1941; 4. 28(112):517–537.
Article
3. Loh LE, Chee TS, John AB. The anatomy of the Fossa of Rosenmuller: its possible influence on the detection of occult nasopharyngeal carcinoma. Singapore Med J. 1991; 6. 32(3):154–155. PMID: 1876886.
4. Sham JS, Wei WI, Zong YS, Choy D, Guo YQ, Luo Y, et al. Detection of subclinical nasopharyngeal carcinoma by fibreoptic endoscopy and multiple biopsy. Lancet. 1990; 2. 17. 335(8686):371–374. PMID: 1968116.
5. Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J. Cancer Incidence in Five Continents, Vol. VII. IARC Scientific Publications No. 143. c1997. Lyon: International Agency for Research on Cancer;p. 814–815.
6. Nielsen NH, Mikkelsen F, Hansen JP. Nasopharyngeal cancer in Greenland: the incidence in an Arctic Eskimo population. Acta Pathol Microbiol Scand A. 1977; 11. 85(6):850–858. PMID: 203161.
7. Dickson RI, Flores AD. Nasopharyngeal carcinoma: an evaluation of 134 patients treated between 1971-1980. Laryngoscope. 1985; 3. 95(3):276–283. PMID: 3974378.
8. Buell P. The effect of migration on the risk of nasopharyngeal cancer among Chinese. Cancer Res. 1974; 5. 34(5):1189–1191. PMID: 4842361.
9. Lee AW, Foo W, Law SC, Poon YF, Sze WM, O SK, et al. Nasopharyngeal carcinoma: presenting symptoms and duration before diagnosis. Hong Kong Med J. 1997; 12. 3(4):355–361. PMID: 11847385.
10. Ozyar E, Atahan IL, Akyol FH, Gurkaynak M, Zorlu AF. Cranial nerve involvement in nasopharyngeal carcinoma: its prognostic role and response to radiotherapy. Radiat Med. 1994; Mar–Apr. 12(2):65–68. PMID: 8079005.
11. Sham JS, Poon YF, Wei WI, Choy D. Nasopharyngeal carcinoma in young patients. Cancer. 1990; 6. 01. 65(11):2606–2610. PMID: 2337878.
Article
12. Godtfredsen E. Chapter III: on the histopathology of malignant nasopharyngeal tumours. Acta Pathol Microbiol Scand. 1944; 32(Suppl 59):38–56.
13. Svoboda D, Kirchner F, Shanmugaratnam K. Ultrastructure of nasopharyngeal carcinomas in American and Chinese patients; an application of electron microscopy to geographic pathology. Exp Mol Pathol. 1965; 4. 28:189–204. PMID: 14319276.
14. Prasad U. Cells of origin of nasopharyngeal carcinoma: an electron microscopic study. J Laryngol Otol. 1974; 11. 88(11):1087–1094. PMID: 4424094.
Article
15. Shanmugaratnamm K, Sobin LH. International histological classification of tumours: No. 19. c1991. 2nd ed. Geneva: World Health Organization.
16. Micheau C, Rilke F, Pilotti S. Proposal for a new histopathological classification of the carcinomas of the nasopharynx. Tumori. 1978; 10. 31. 64(5):513–518. PMID: 746599.
Article
17. Reddy SP, Raslan WF, Gooneratne S, Kathuria S, Marks JE. Prognostic significance of keratinization in nasopharyngeal carcinoma. Am J Otolaryngol. 1995; Mar–Apr. 16(2):103–108. PMID: 7540805.
Article
18. Marks JE, Phillips JL, Menck HR. The National Cancer Data Base report on the relationship of race and national origin to the histology of nasopharyngeal carcinoma. Cancer. 1998; 8. 01. 83(3):582–588. PMID: 9690553.
Article
19. Nicholls JM. Nasopharyngeal carcinoma: classification and histological appearances. Adv Anat Pathol. 1997; 4(2):71–84.
20. Gulley ML. Molecular diagnosis of Epstein-Barr virus-related diseases. J Mol Diagn. 2001; 2. 3(1):1–10. PMID: 11227065.
Article
21. Zeng Y, Zhang LG, Wu YC, Huang YS, Huang NQ, Li JY, et al. Prospective studies on nasopharyngeal carcinoma in Epstein-Barr virus IgA/VCA antibody-positive persons in Wuzhou City, China. Int J Cancer. 1985; 11. 15. 36(5):545–547. PMID: 4055129.
22. Chien YC, Chen JY, Liu MY, Yang HI, Hsu MM, Chen CJ, et al. Serologic markers of Epstein-Barr virus infection and nasopharyngeal carcinoma in Taiwanese men. N Engl J Med. 2001; 12. 27. 345(26):1877–1882. PMID: 11756578.
Article
23. Mutirangura A, Pornthanakasem W, Theamboonlers A, Sriuranpong V, Lertsanguansinchi P, Yenrudi S, et al. Epstein-Barr viral DNA in serum of patients with nasopharyngeal carcinoma. Clin Cancer Res. 1998; 3. 4(3):665–669. PMID: 9533535.
24. Lo YM, Leung SF, Chan LY, Chan AT, Lo KW, Johnson PJ, et al. Kinetics of plasma Epstein-Barr virus DNA during radiation therapy for nasopharyngeal carcinoma. Cancer Res. 2000; 5. 01. 60(9):2351–2355. PMID: 10811107.
25. Hong RL, Lin CY, Ting LL, Ko JY, Hsu MM. Comparison of clinical and molecular surveillance in patients with advanced nasopharyngeal carcinoma after primary therapy: the potential role of quantitative analysis of circulating Epstein-Barr virus DNA. Cancer. 2004; 4. 01. 100(7):1429–1437. PMID: 15042677.
26. Lin JC, Wang WY, Chen KY, Wei YH, Liang WM, Jan JS, et al. Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma. N Engl J Med. 2004; 6. 10. 350(24):2461–2470. PMID: 15190138.
Article
27. Leung SF, Chan AT, Zee B, Ma B, Chan LY, Johnson PJ, et al. Pretherapy quantitative measurement of circulating Epstein-Barr virus DNA is predictive of posttherapy distant failure in patients with early-stage nasopharyngeal carcinoma of undifferentiated type. Cancer. 2003; 7. 15. 98(2):288–291. PMID: 12872347.
Article
28. Chan AT, Lo YM, Zee B, Chan LY, Ma BB, Leung SF, et al. Plasma Epstein-Barr virus DNA and residual disease after radiotherapy for undifferentiated nasopharyngeal carcinoma. J Natl Cancer Inst. 2002; 11. 06. 94(21):1614–1619. PMID: 12419787.
Article
29. Leung SF, Tam JS, Chan AT, Zee B, Chan LY, Huang DP, et al. Improved accuracy of detection of nasopharyngeal carcinoma by combined application of circulating Epstein-Barr virus DNA and anti-Epstein-Barr viral capsid antigen IgA antibody. Clin Chem. 2004; 2. 50(2):339–345. PMID: 14684618.
Article
30. Wei WI, Yuen AP, Ng RW, Ho WK, Kwong DL, Sham JS. Quantitative analysis of plasma cell-free Epstein-Barr virus DNA in nasopharyngeal carcinoma after salvage nasopharyngectomy: a prospective study. Head Neck. 2004; 10. 26(10):878–883. PMID: 15390201.
Article
31. Sham JS, Cheung YK, Choy D, Chan FL, Leong L. Nasopharyngeal carcinoma: CT evaluation of patterns of tumor spread. AJNR Am J Neuroradiol. 1991; Mar–Apr. 12(2):265–270. PMID: 1902025.
32. Chong VF, Fan YF, Khoo JB. Nasopharyngeal carcinoma with intracranial spread: CT and MR characteristics. J Comput Assist Tomogr. 1996; Jul–Aug. 20(4):563–569. PMID: 8708057.
Article
33. Dillon WP, Mills CM, Kjos B, DeGroot J, Brant-Zawadzki M. Magnetic resonance imaging of the nasopharynx. Radiology. 1984; 9. 152(3):731–738. PMID: 6463254.
Article
34. Cheng SH, Jian JJ, Tsai SY, Chan KY, Yen LK, Chu NM, et al. Prognostic features and treatment outcome in locoregionally advanced nasopharyngeal carcinoma following concurrent chemotherapy and radiotherapy. Int J Radiat Oncol Biol Phys. 1998; 7. 01. 41(4):755–762. PMID: 9652835.
Article
35. Olmi P, Fallai C, Colagrande S, Giannardi G. Staging and follow-up of nasopharyngeal carcinoma: magnetic resonance imaging versus computerized tomography. Int J Radiat Oncol Biol Phys. 1995; 6. 15. 32(3):795–800. PMID: 7790266.
Article
36. Sham JS, Tong CM, Choy D, Yeung DW. Role of bone scanning in detection of subclinical bone metastasis in nasopharyngeal carcinoma. Clin Nucl Med. 1991; 1. 16(1):27–29. PMID: 1999052.
Article
37. Kraiphibul P, Atichartakarn V, Clongsusuek P, Kulapaditharom B, Ratanatharathorn V, Chokewattanaskul P. Nasopharyngeal carcinoma: value of bone and liver scintigraphy in the pre-treatment and follow-up period. J Med Assoc Thai. 1991; 7. 74(7):276–279. PMID: 1662680.
38. Leung SF, Metreweli C, Tsao SY, Van Hasselt CA. Staging abdominal ultrasonography in nasopharyngeal carcinoma. Australas Radiol. 1991; 2. 35(1):31–32. PMID: 1859321.
Article
39. Sham JS, Chan LC, Loke SL, Choy D. Nasopharyngeal carcinoma: role of marrow biopsy at diagnosis. Oncology. 1991; 48(6):480–482. PMID: 1749586.
Article
40. Nakamoto Y, Osman M, Wahl RL. Prevalence and patterns of bone metastases detected with positron emission tomography using F-18 FDG. Clin Nucl Med. 2003; 4. 28(4):302–307. PMID: 12642709.
Article
41. Yen RF, Hung RL, Pan MH, Wang YH, Huang KM, Lui LT, et al. 18-fluoro-2-deoxyglucose positron emission tomography in detecting residual/ recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging. Cancer. 2003; 7. 15. 98(2):283–287. PMID: 12872346.
42. Cellai E, Olmi P, Chiavacci A, Giannardi G, Fargnoli R, Villari N, et al. Computed tomography in nasopharyngeal carcinoma: Part II: Impact on survival. Int J Radiat Oncol Biol Phys. 1990; 11. 19(5):1177–1182. PMID: 2254109.
Article
43. Emami B, Sethi A, Petruzzelli GJ. Influence of MRI on target volume delineation and IMRT planning in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2003; 10. 01. 57(2):481–488. PMID: 12957260.
Article
44. Sobin LH, Wittekind CH. TNM classification of malignant tumours. 1997. 5th ed. New York: Wiley-Liss;p. 227.
45. Ho JH. An epidemiologic and clinical study of nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1978; Mar–Apr. 4(3-4):182–198. PMID: 640889.
Article
46. Ho JH. Stage classification of nasopharyngeal carcinoma: a review. IA RC Sci Publ. 1978; (20):99–113.
47. Sham JS, Cheung YK, Choy D, Chan FL, Leong L. Cranial nerve involvement and base of the skull erosion in nasopharyngeal carcinoma. Cancer. 1991; 7. 15. 68(2):422–426. PMID: 2070338.
Article
48. Chua DT, Sham JS, Kwong DL, Choy DT, Au GK, Wu PM. Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma: a significant factor in local control and distant metastasis. Cancer. 1996; 7. 15. 78(2):202–210. PMID: 8673993.
Article
49. Teo P, Yu P, Lee WY, Leung SF, Kwan WH, Yu KH, et al. Significant prognosticators after primary radiotherapy in 903 nondisseminated nasopharyngeal carcinoma evaluated by computer tomography. Int J Radiat Oncol Biol Phys. 1996; 9. 01. 36(2):291–304. PMID: 8892451.
Article
50. Fleming ID, Cooper JS, Henson DE, Hutter RVP, Kennedy BJ, Murphy GP, et al. AJCC cancer staging manual. c1997. Philadelphia: Lippincott-Raven;p. 294.
51. Lee AW, Foo W, Law SC, Poon YF, O SK, Tung SY, et al. Staging of nasopharyngeal carcinoma: from Ho's to the new UICC system. Int J Cancer. 1999; 4. 20. 84(2):179–187. PMID: 10096252.
Article
52. Cooper JS, Cohen R, Stevens RE. A comparison of staging systems for nasopharyngeal carcinoma. Cancer. 1998; 7. 15. 83(2):213–219. PMID: 9669802.
Article
53. Ozyar E, Yildiz F, Akyol FH, Atahan IL. Comparison of AJCC 1988 and 1997 classifications for nasopharyngeal carcinoma. American Joint Committee on Cancer. Int J Radiat Oncol Biol Phys. 1999; 7. 15. 44(5):1079–1087. PMID: 10421542.
54. Perez CA, Devineni VR, Marcial-Vega V, Marks JE, Simpson JR, Kucik N. Carcinoma of the nasopharynx: factors affecting prognosis. Int J Radiat Oncol Biol Phys. 1992; 23(2):271–280. PMID: 1587746.
Article
55. Sham JS, Choy D. Prognostic value of paranasopharyngeal extension of nasopharyngeal carcinoma on local control and short-term survival. Head Neck. 1991; Jul–Aug. 13(4):298–310. PMID: 1869431.
Article
56. Chua DT, Sham JS, Kwong DL, Tai KS, Wu PM, Lo M, et al. Volumetric analysis of tumor extent in nasopharyngeal carcinoma and correlation with treatment outcome. Int J Radiat Oncol Biol Phys. 1997; 10. 01. 39(3):711–719. PMID: 9336154.
Article
57. Chang CC, Chen MK, Liu MT, Wu HK. The effect of primary tumor volumes in advanced T-staged nasopharyngeal tumors. Head Neck. 2002; 10. 24(10):940–946. PMID: 12369073.
Article
58. Sze WM, Lee AW, Yau TK, Yeung RM, Lau KY, Leung SK, et al. Primary tumor volume of nasopharyngeal carcinoma: prognostic significance for local control. Int J Radiat Oncol Biol Phys. 2004; 5. 01. 59(1):21–27. PMID: 15093895.
Article
59. Lo YM. Quantitative analysis of Epstein-Barr virus DNA in plasma and serum: applications to tumor detection and monitoring. Ann N Y Acad Sci. 2001; 9. 945:68–72. PMID: 11708496.
60. Chua DT, Sham JS, Wei WI, Ho WK, Au GK. The predictive value of the 1997 American Joint Committee on Cancer stage classification in determining failure patterns in nasopharyngeal carcinoma. Cancer. 2001; 12. 01. 92(11):2845–2855. PMID: 11753958.
Article
61. Mesic JB, Fletcher GH, Goepfert H. Megavoltage irradiation of epithelial tumors of the nasopharynx. Int J Radiat Oncol Biol Phys. 1981; 4. 7(4):447–453. PMID: 6788731.
Article
62. Hoppe RT, Goffinet DR, Bagshaw MA. Carcinoma of the nasopharynx: eighteen years' experience with megavoltage radiation therapy. Cancer. 1976; 6. 37(6):2605–2612. PMID: 820419.
63. Lee AW, Poon YF, Foo W, Law SC, Cheung FK, Chan DK, et al. Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976-1985: overall survival and patterns of failure. Int J Radiat Oncol Biol Phys. 1992; 23(2):261–270. PMID: 1587745.
Article
64. Wang CC. Improved local control of nasopharyngeal carcinoma after intracavitary brachytherapy boost. Am J Clin Oncol. 1991; 2. 14(1):5–8. PMID: 1987739.
Article
65. Kwong DL, Sham JS, Chua DT, Choy DT, Au GK, Wu PM. The effect of interruptions and prolonged treatment time in radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1997; 10. 01. 39(3):703–710. PMID: 9336153.
Article
66. Lee AW, Sham JS, Poon YF, Ho JH. Treatment of stage I nasopharyngeal carcinoma: analysis of the patterns of relapse and the results of withholding elective neck irradiation. Int J Radiat Oncol Biol Phys. 1989; 12. 17(6):1183–1190. PMID: 2513290.
Article
67. Kwong D, Sham J, Choy D. The effect of loco-regional control on distant metastatic dissemination in carcinoma of the nasopharynx: an analysis of 1301 patients. Int J Radiat Oncol Biol Phys. 1994; 12. 01. 30(5):1029–1036. PMID: 7961008.
Article
68. Levendag PC, Lagerwaard FJ, de Pan C, Noever I, van Nimwegen A, Wijers O, et al. High-dose, high-precision treatment options for boosting cancer of the nasopharynx. Radiother Oncol. 2002; 4. 63(1):67–74. PMID: 12065105.
Article
69. Le QT, Tate D, Koong A, Gibbs IC, Chang SD, Adler JR, et al. Improved local control with stereotactic radiosurgical boost in patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2003; 7. 15. 56(4):1046–1054. PMID: 12829140.
Article
70. Chua DT, Sham JS, Kwong PW, Hung KN, Leung LH. Linear accelerator-based stereotactic radiosurgery for limited, locally persistent, and recurrent nasopharyngeal carcinoma: efficacy and complications. Int J Radiat Oncol Biol Phys. 2003; 5. 01. 56(1):177–183. PMID: 12694836.
Article
71. Waldron J, Tin MM, Keller A, Lum C, Japp B, Sellmann S, et al. Limitation of conventional two dimensional radiation therapy planning in nasopharyngeal carcinoma. Radiother Oncol. 2003; 8. 68(2):153–161. PMID: 12972310.
Article
72. Cheng JC, Chao KS, Low D. Comparison of intensity modulated radiation therapy (IMRT) treatment techniques for nasopharyngeal carcinoma. Int J Cancer. 2001; 4. 20. 96(2):126–131. PMID: 11291096.
Article
73. Wu VW, Kwong DL, Sham JS. Target dose conformity in 3-dimensional conformal radiotherapy and intensity modulated radiotherapy. Radiother Oncol. 2004; 5. 71(2):201–206. PMID: 15110454.
Article
74. Hsiung CY, Yorke ED, Chui CS, Hunt MA, Ling CC, Huang EY, et al. Intensity-modulated radiotherapy versus conventional three-dimensional conformal radiotherapy for boost or salvage treatment of nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2002; 7. 01. 53(3):638–647. PMID: 12062607.
Article
75. Withers HR, Thames HD. Dose fractionation and volume effects in normal tissues and tumors. Am J Clin Oncol. 1988; 6. 11(3):313–329. PMID: 3289364.
Article
76. Butler EB, Teh BS, Grant WH 3rd, Uhl BM, Kuppersmith RB, Chiu JK, et al. Smart (simultaneous modulated accelerated radiation therapy) boost: a new accelerated fractionation schedule for the treatment of head and neck cancer with intensity modulated radiotherapy. Int J Radiat Oncol Biol Phys. 1999; 8. 01. 45(1):21–32. PMID: 10477002.
Article
77. Lee N, Xia P, Quivey JM, Sultanem K, Poon I, Akazawa C, et al. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys. 2002; 5. 01. 53(1):12–22. PMID: 12007936.
Article
78. Wolden SL, Chen WC, Pfister DG, Kraus DH, Berry SL, Zelefsky MJ. Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience. Int J Radiat Oncol Biol Phys. 2006; 1. 01. 64(1):57–62. PMID: 15936155.
Article
79. Kam MK, Teo PM, Chau RM, Cheung KY, Choi PH, Kwan WH, et al. Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: the Hong Kong experience. Int J Radiat Oncol Biol Phys. 2004; 12. 01. 60(5):1440–1450. PMID: 15590175.
Article
80. Kwong DL, Pow EH, Sham JS, McMillan AS, Leung LH, Leung WK, et al. Intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma: a prospective study on disease control and preservation of salivary function. Cancer. 2004; 10. 01. 101(7):1584–1593. PMID: 15378492.
81. Tham IW, Hee SW, Yeo RM, Salleh PB, Lee J, Tan TW, et al. Treatment of nasopharyngeal carcinoma using intensity-modulated radiotherapy-the national cancer centre singapore experience. Int J Radiat Oncol Biol Phys. 2009; 12. 01. 75(5):1481–1486. PMID: 19386431.
Article
82. Kwong DL, Sham JS, Leung LH, Cheng AC, Ng WM, Kwong PW, et al. Preliminary results of radiation dose escalation for locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006; 2. 01. 64(2):374–381. PMID: 16213105.
Article
83. Pow EH, Kwong DL, McMillan AS, Wong MC, Sham JS, Leung LH, et al. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys. 2006; 11. 15. 66(4):981–991. PMID: 17145528.
Article
84. Kam MK, Leung SF, Zee B, Chau RM, Suen JJ, Mo F, et al. Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. J Clin Oncol. 2007; 11. 01. 25(31):4873–4879. PMID: 17971582.
Article
85. McMillan AS, Pow EH, Kwong DL, Wong MC, Sham JS, Leung LH, et al. Preservation of quality of life after intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma: results of a prospective longitudinal study. Head Neck. 2006; 8. 28(8):712–722. PMID: 16475203.
86. Lee N, Harris J, Garden AS, Straube W, Glisson B, Xia P, et al. Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase II trial 0225. J Clin Oncol. 2009; 8. 01. 27(22):3684–3690. PMID: 19564532.
Article
87. Rossi A, Molinari R, Boracchi P, Del Vecchio M, Marubini E, Nava M, et al. Adjuvant chemotherapy with vincristine, cyclophosphamide, and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: results of a 4-year multicenter randomized study. J Clin Oncol. 1988; 9. 6(9):1401–1410. PMID: 3047335.
Article
88. Harrison LB, Pfister DG, Bosl GJ. Chemotherapy as part of the initial treatment for nasopharyngeal cancer. Oncology (Williston Park). 1991; 2. 5(2):67–70. PMID: 1826210.
89. Turner SL, Tiver KW. Synchronous radiotherapy and chemotherapy in the treatment of nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1993; 9. 30. 27(2):371–377. PMID: 8407412.
Article
90. Chan AT, Teo PM, Leung TW, Leung SF, Lee WY, Yeo W, et al. A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1995; 10. 15. 33(3):569–577. PMID: 7558945.
Article
91. Teo PM, Leung TW, Chan AT, Yu P, Lee WY, Leung SF, et al. A retrospective study of the use of cisplatinum-5-fluorouracil neoadjuvant chemotherapy in cervical-node-positive nasopharyngeal carcinoma (NPC). Eur J Cancer B Oral Oncol. 1995; 11. 31B(6):373–379. PMID: 8746267.
Article
92. Preliminary results of a randomized trial comparing neoadjuvant chemotherapy (cisplatin, epirubicin, bleomycin) plus radiotherapy vs. radiotherapy alone in stage IV(> or = N2, M0) undifferentiated nasopharyngeal carcinoma: a positive effect on progression-free survival. International Nasopharynx Cancer Study Group. VUMCA I trial. Int J Radiat Oncol Biol Phys. 1996; 6. 01. 35(3):463–469. PMID: 8655368.
93. Garden AS, Lippman SM, Morrison WH, Glisson BS, Ang KK, Geara F, et al. Does induction chemotherapy have a role in the management of nasopharyngeal carcinoma? Results of treatment in the era of computerized tomography. Int J Radiat Oncol Biol Phys. 1996; 12. 01. 36(5):1005–1012. PMID: 8985020.
Article
94. Lin JC, Chen KY, Jan JS, Hsu CY. Partially hyperfractionated accelerated radiotherapy and concurrent chemotherapy for advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1996; 12. 01. 36(5):1127–1136. PMID: 8985035.
Article
95. Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 1998; 4. 16(4):1310–1317. PMID: 9552031.
Article
96. Chua DT, Sham JS, Choy D, Lorvidhaya V, Sumitsawan Y, Thongprasert S, et al. Preliminary report of the Asian-Oceanian Clinical Oncology Association randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma: Asian-Oceanian Clinical Oncology Association Nasopharynx Cancer Study Group. Cancer. 1998; 12. 01. 83(11):2270–2283. PMID: 9840526.
97. Lee AW, Lau WH, Tung SY, Chua DT, Chappell R, Xu L, et al. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol. 2005; 10. 01. 23(28):6966–6975. PMID: 16192584.
Article
98. Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, et al. Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol. 2005; 9. 20. 23(27):6730–6738. PMID: 16170180.
Article
99. Chen Y, Liu MZ, Liang SB, Zong JF, Mao YP, Tang LL, et al. Preliminary results of a prospective randomized trial comparing concurrent chemoradiotherapy plus adjuvant chemotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma in endemic regions of china. Int J Radiat Oncol Biol Phys. 2008; 8. 01. 71(5):1356–1364. PMID: 18472356.
Article
100. Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT, et al. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys. 2006; 1. 01. 64(1):47–56. PMID: 16377415.
Article
101. Kwong DL, Sham JS, Au GK, Chua DT, Kwong PW, Cheng AC, et al. Concurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: a factorial study. J Clin Oncol. 2004; 7. 01. 22(13):2643–2653. PMID: 15226332.
Article
102. Chi KH, Chang YC, Guo WY, Leung MJ, Shiau CY, Chen SY, et al. A phase III study of adjuvant chemotherapy in advanced nasopharyngeal carcinoma patients. Int J Radiat Oncol Biol Phys. 2002; 4. 01. 52(5):1238–1244. PMID: 11955734.
Article
103. Fang FM, Chiu HC, Kuo WR, Wang CJ, Leung SW, Chen HC, et al. Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment. Int J Radiat Oncol Biol Phys. 2002; 7. 15. 53(4):959–968. PMID: 12095563.
Article
104. McMillan AS, Pow EH, Leung WK, Wong MC, Kwong DL. Oral health-related quality of life in southern Chinese following radiotherapy for nasopharyngeal carcinoma. J Oral Rehabil. 2004; 6. 31(6):600–608. PMID: 15189320.
Article
105. Ho WK, Wei WI, Kwong DL, Sham JS, Tai PT, Yuen AP, et al. Long-term sensorineural hearing deficit following radiotherapy in patients suffering from nasopharyngeal carcinoma: a prospective study. Head Neck. 1999; 9. 21(6):547–553. PMID: 10449671.
Article
106. Lam KS, Tse VK, Wang C, Yeung RT, Ho JH. Effects of cranial irradiation on hypothalamic-pituitary function: a 5-year longitudinal study in patients with nasopharyngeal carcinoma. Q J Med. 1991; 2. 78(286):165–176. PMID: 1851569.
107. Pow EH, McMillan AS, Leung WK, Wong MC, Kwong DL. Salivary gland function and xerostomia in southern Chinese following radiotherapy for nasopharyngeal carcinoma. Clin Oral Investig. 2003; 12. 7(4):230–234.
Article
108. Pow EH, McMillan AS, Leung WK, Kwong DL, Wong MC. Oral health condition in southern Chinese after radiotherapy for nasopharyngeal carcinoma: extent and nature of the problem. Oral Dis. 2003; 7. 9(4):196–202. PMID: 12974519.
Article
109. Leung SF, Zheng Y, Choi CY, Mak SS, Chiu SK, Zee B, et al. Quantitative measurement of post-irradiation neck fibrosis based on the young modulus: description of a new method and clinical results. Cancer. 2002; 8. 01. 95(3):656–662. PMID: 12209759.
110. Cheng SW, Ting AC, Lam LK, Wei WI. Carotid stenosis after radiotherapy for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2000; 4. 126(4):517–521. PMID: 10772307.
Article
111. Lee AW, Kwong DL, Leung SF, Tung SY, Sze WM, Sham JS, et al. Factors affecting risk of symptomatic temporal lobe necrosis: significance of fractional dose and treatment time. Int J Radiat Oncol Biol Phys. 2002; 5. 01. 53(1):75–85. PMID: 12007944.
Article
112. Lin YS, Jen YM, Lin JC. Radiation-related cranial nerve palsy in patients with nasopharyngeal carcinoma. Cancer. 2002; 7. 15. 95(2):404–409. PMID: 12124841.
Article
113. Chang YC, Chen SY, Lui LT, Wang TG, Wang TC, Hsiao TY, et al. Dysphagia in patients with nasopharyngeal cancer after radiation therapy: a videofluoroscopic swallowing study. Dysphagia. 2003; Spring. 18(2):135–143. PMID: 12825907.
Article
114. Lam LC, Leung SF, Chan YL. Progress of memory function after radiation therapy in patients with nasopharyngeal carcinoma. J Neuropsychiatry Clin Neurosci. 2003; Winter. 15(1):90–97. PMID: 12556578.
Article
115. Cheung M, Chan AS, Law SC, Chan JH, Tse VK. Cognitive function of patients with nasopharyngeal carcinoma with and without temporal lobe radionecrosis. Arch Neurol. 2000; 9. 57(9):1347–1352. PMID: 10987903.
Article
116. Lee PW, Hung BK, Woo EK, Tai PT, Choi DT. Effects of radiation therapy on neuropsychological functioning in patients with nasopharyngeal carcinoma. J Neurol Neurosurg Psychiatry. 1989; 4. 52(4):488–492. PMID: 2786925.
Article
117. Lee AW, Law SC, Ng SH, Chan DK, Poon YF, Foo W, et al. Retrospective analysis of nasopharyngeal carcinoma treated during 1976-1985: late complications following megavoltage irradiation. Br J Radiol. 1992; 10. 65(778):918–928. PMID: 1422667.
Article
118. Sham J, Choy D, Kwong PW, Cheng AC, Kwong DL, Yau CC, et al. Radiotherapy for nasopharyngeal carcinoma: shielding the pituitary may improve therapeutic ratio. Int J Radiat Oncol Biol Phys. 1994; 7. 01. 29(4):699–704. PMID: 8040015.
Article
119. Kao CH, Tsai SC, Wang JJ, Ho YJ, Yen RF, Ho ST. Comparing 18-fluoro-2-deoxyglucose positron emission tomography with a combination of technetium 99m tetrofosmin single photon emission computed tomography and computed tomography to detect recurrent or persistent nasopharyngeal carcinomas after radiotherapy. Cancer. 2001; 7. 15. 92(2):434–439. PMID: 11466699.
Article
120. Wei WI, Ho CM, Wong MP, Ng WF, Lau SK, Lam KH. Pathological basis of surgery in the management of postradiotherapy cervical metastasis in nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 1992; 9. 118(9):923–929. PMID: 1503717.
Article
121. Chua DT, Wei WI, Sham JS, Cheng AC, Au G. Treatment outcome for synchronous locoregional failures of nasopharyngeal carcinoma. Head Neck. 2003; 7. 25(7):585–594. PMID: 12808662.
Article
122. Huang SC, Lui LT, Lynn TC. Nasopharyngeal cancer: study III. A review of 1206 patients treated with combined modalities. Int J Radiat Oncol Biol Phys. 1985; 10. 11(10):1789–1793. PMID: 2412999.
Article
123. Sham JS, Choy D. Nasopharyngeal carcinoma: treatment of neck node recurrence by radiotherapy. Australas Radiol. 1991; 11. 35(4):370–373. PMID: 1812832.
Article
124. Wei WI, Lam KH, Ho CM, Sham JS, Lau SK. Efficacy of radical neck dissection for the control of cervical metastasis after radiotherapy for nasopharyngeal carcinoma. Am J Surg. 1990; 10. 160(4):439–442. PMID: 2221251.
Article
125. Wei WI, Ho WK, Cheng AC, Wu X, Li GK, Nicholls J, et al. Management of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: a clinicopathological study. Arch Otolaryngol Head Neck Surg. 2001; 12. 127(12):1457–1462. PMID: 11735814.
126. Lee AW, Law SC, Foo W, Poon YF, Cheung FK, Chan DK, et al. Retrospective analysis of patients with nasopharyngeal carcinoma treated during 1976-1985: survival after local recurrence. Int J Radiat Oncol Biol Phys. 1993; 8. 01. 26(5):773–782. PMID: 8344845.
Article
127. Xiao J, Xu G, Miao Y. Fractionated stereotactic radiosurgery for 50 patients with recurrent or residual nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2001; 9. 01. 51(1):164–170. PMID: 11516866.
Article
128. Wang CC, Busse J, Gitterman M. A simple afterloading applicator for intracavitary irradiation of carcinoma of the nasopharynx. Radiology. 1975; 6. 115(3):737–738. PMID: 1129494.
Article
129. Harrison LB, Weissberg JB. A technique for interstitial nasopharyngeal brachytherapy. Int J Radiat Oncol Biol Phys. 1987; 3. 13(3):451–453. PMID: 3558031.
Article
130. Wei WI, Sham JS, Choy D, Ho CM, Lam KH. Split-palate approach for gold grain implantation in nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 1990; 5. 116(5):578–582. PMID: 2328116.
Article
131. Choy D, Sham JS, Wei WI, Ho CM, Wu PM. Transpalatal insertion of radioactive gold grain for the treatment of persistent and recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1993; 2. 15. 25(3):505–512. PMID: 8382202.
Article
132. Kwong DL, Wei WI, Cheng AC, Choy DT, Lo AT, Wu PM, et al. Long term results of radioactive gold grain implantation for the treatment of persistent and recurrent nasopharyngeal carcinoma. Cancer. 2001; 3. 15. 91(6):1105–1113. PMID: 11267955.
Article
133. Leung TW, Tung SY, Wong VY, Lui CM, Sze WK, Cheung KL, et al. High dose rate intracavitary brachytherapy in the treatment of nasopharyngeal carcinoma. Acta Oncol. 1996; 35(1):43–47. PMID: 8619939.
Article
134. Law SC, Lam WK, Ng MF, Au SK, Mak WT, Lau WH. Reirradiation of nasopharyngeal carcinoma with intracavitary mold brachytherapy: an effective means of local salvage. Int J Radiat Oncol Biol Phys. 2002; 11. 15. 54(4):1095–1113. PMID: 12419437.
Article
135. Fisch U. The infratemporal fossa approach for nasopharyngeal tumors. Laryngoscope. 1983; 1. 93(1):36–44. PMID: 6185810.
136. Fee WE Jr, Roberson JB Jr, Goffinet DR. Long-term survival after surgical resection for recurrent nasopharyngeal cancer after radiotherapy failure. Arch Otolaryngol Head Neck Surg. 1991; 11. 117(11):1233–1236. PMID: 1747224.
Article
137. Morton RP, Liavaag PG, McLean M, Freeman JL. Transcervico-mandibulo-palatal approach for surgical salvage of recurrent nasopharyngeal cancer. Head Neck. 1996; Jul–Aug. 18(4):352–358. PMID: 8780947.
Article
138. Wei WI, Lam KH, Sham JS. New approach to the nasopharynx: the maxillary swing approach. Head Neck. 1991; May–Jun. 13(3):200–207. PMID: 2037471.
Article
139. Wei WI. Cancer of the nasopharynx: functional surgical salvage. World J Surg. 2003; 7. 27(7):844–848. PMID: 14509517.
Article
140. Ng RW, Wei WI. Elimination of palatal fistula after the maxillary swing procedure. Head Neck. 2005; 7. 27(7):608–612. PMID: 15920745.
Article
141. Fee WE Jr, Moir MS, Choi EC, Goffinet D. Nasopharyngectomy for recurrent nasopharyngeal cancer: a 2- to 17-year follow-up. Arch Otolaryngol Head Neck Surg. 2002; 3. 128(3):280–284. PMID: 11886344.
142. Wei WI. Nasopharyngeal cancer: current status of management: a New York Head and Neck Society lecture. Arch Otolaryngol Head Neck Surg. 2001; 7. 127(7):766–769. PMID: 11448346.
143. Roh JL. Transpalatal endoscopic resection of residual nasopharyngeal carcinoma after sequential chemoradiotherapy. J Laryngol Otol. 2004; 12. 118(12):951–954. PMID: 15667682.
Article
144. Chen MY, Wen WP, Guo X, Yang AK, Qian CN, Hua YJ, et al. Endoscopic nasopharyngectomy for locally recurrent nasopharyngeal carcinoma. Laryngoscope. 2009; 3. 119(3):516–522. PMID: 19235750.
Article
145. Chen MK, Lai JC, Chang CC, Liu MT. Minimally invasive endoscopic nasopharyngectomy in the treatment of recurrent T1-2a nasopharyngeal carcinoma. Laryngoscope. 2007; 5. 117(5):894–896. PMID: 17473691.
Article
146. Leung TW, Tung SY, Sze WK, Sze WM, Wong VY, Wong CS, et al. Salvage radiation therapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2000; 12. 01. 48(5):1331–1338. PMID: 11121630.
Article
147. Poon D, Yap SP, Wong ZW, Cheung YB, Leong SS, Wee J, et al. Concurrent chemoradiotherapy in locoregionally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2004; 8. 01. 59(5):1312–1318. PMID: 15275714.
Article
148. Chua DT, Sham JS, Leung LH, Au GK. Re-irradiation of nasopharyngeal carcinoma with intensity-modulated radiotherapy. Radiother Oncol. 2005; 12. 77(3):290–294. PMID: 16289398.
149. Cheng SH, Jian JJ, Tsai SY, Yen KL, Chu NM, Chan KY, et al. Long-term survival of nasopharyngeal carcinoma following concomitant radiotherapy and chemotherapy. Int J Radiat Oncol Biol Phys. 2000; 12. 01. 48(5):1323–1330. PMID: 11121629.
Article
150. Pignon JP, le Maitre A, Maillard E, Bourhis J. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol. 2009; 7. 92(1):4–14. PMID: 19446902.
Article
151. Hospital authority [Internet]. cited 2010 Feb. 5. Kowloon: Hospital authority;Available from: http://www.ha.org.hk/pyneh/onc/ctrial.html.
152. A phase III study of concurrent chemoradiotherapy using dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) + bevacizumab (BV) locally or regionally advanced nasopharyngeal cancer [Internet]. 2006. cited 2010 Feb. 5. Reston: Radiation Therapy Oncology Group of the American College of Radiology;Available from: http://www.rtog.org/members/protocols/0615/0615.pdf.
Full Text Links
  • CEO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr