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Japanese Journal of Clinical Oncology Advance Access originally published online on March 6, 2006
Japanese Journal of Clinical Oncology 2006 36(3):132-136; doi:10.1093/jjco/hyi245
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© 2006 Foundation for Promotion of Cancer Research

Treatment Outcomes of Patients with AJCC Stage IVC Nasopharyngeal Carcinoma: Benefits of Primary Radiotherapy

Shyh-An Yeh1, Yeh Tang2, Chun-Chung Lui3 and Eng-Yen Huang1

Departments of 1 Radiation Oncology, 2 Medical Oncology and 3 Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

For reprints and all correspondence: Shyh-An Yeh, 5F., No. 181, Wen-Chuan Road, Zuoying District, Kaohsiung City 81361, Taiwan. E-mail: yehsa{at}hotmail.com

Received October 2, 2005; accepted December 13, 2005

Background: There is no agreement on the optimal management of patients initially presenting with metastatic nasopharyngeal carcinoma. This study was performed to investigate the treatment outcomes and to assess whether radiotherapy to the primary tumors has survival benefits.

Methods: From 1993 to 2001, 806 consecutive patients with histology-proven nasopharyngeal carcinoma were registered at our department. Among them, 125 patients had distant metastases and fulfilled the criteria for stage IVC of the 1997 American Joint Committee on Cancer staging system. Tumor histology according to the World Health Organization classification was Type 2 in 67 patients and Type 3 in 58 patients. The most common site of initial metastasis was bone. A total of 28 patients refused any treatment, 39 received chemotherapy alone and 58 had radiotherapy to the primary tumor sites alone.

Results: The 1 year overall survival rates were 25, 36 and 48% for patients with no treatment, chemotherapy and radiotherapy, respectively. In multivariate analysis, age of diagnosis and treatment modality were confirmed as independent prognostic factors for overall survival.

Conclusions: Based on our results, radiotherapy to the primary tumor sites could be considered for patients with stage IVC nasopharyngeal carcinoma. A combination of radiotherapy and chemotherapy might have potential survival benefits. Further randomized prospective study is necessary to explore the optimal treatment strategy.

Key Words: nasopharyngeal carcinoma • radiotherapy • chemotherapy • metastasis


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