Radiotherapy alone provides good outcome for stage I nasopharyngeal carcinoma

Patients with stage I nasopharyngeal carcinoma have an excellent outcome after radiotherapy alone, results of a report in the July 1st issue of Cancer suggest. However, patients with stage II disease have a relatively worse outcome, and more aggressive therapy may be warranted.

Dr. Jonathan S. T. Sham and colleagues from the University of Hong Kong examined the long-term outcome of 141 patients with American Joint Committee on Cancer (AJCC) 1997 stage I-II nasopharyngeal carcinoma who were treated with radiotherapy alone. Lymph node disease was present in 57 patients, and the median greatest lymph node diameter was 3 cm. The patients were followed for a median of 82 months.The outcome after radiotherapy was “excellent” in patients with stage I disease (n = 50), they report. Two patients experienced local failure, one had lymph node failure, and one had distant failure. The 10-year rates of disease-specific survival and recurrence-free survival were 98% and 94%, respectively. The 10-year rates of local recurrence free survival, lymph mode recurrence free survival and distant metastasis free survival were 96%, 98%, and 98%, respectively.Compared to patients with stage I disease, those with stage II disease (n = 91) had a worse outcome. Fifteen patients experienced local failure, three had lymph node failure, and 25 had distant failure. The 10-year disease specific survival and recurrence free survival rates were 60% and 51%, respectively. The 10-year local recurrence free survival, lymph node recurrence free survival and distant metastasis free survival rates were 78%, 93%, and 64%, respectively.”Among patients who had stage II disease, those with T1-T2N1 nasopharyngeal carcinoma appeared to have a worse outcome compared with patients who had T2N0 nasopharyngeal carcinoma,” Dr. Sham and colleagues explain. “No significant differences in survival rates were found with respect to lymph node size or status for patients with T1-T2N1 disease.”They conclude that stage II patients, particularly those with T1-T2N1 disease, may be candidates for “more aggressive therapy, such as combined-modality treatment.”(Source: Cancer 2003;98:74-80: Reuters Health: July 16, 2003: Oncolink)