Treatment outcomes of the patients with nasopharynx carcinoma and examination of the prognostic factors

PURPOSE: In this study, our aim was to investigate treatment outcomes of patients with nasopharynx carcinoma, together with the prognostic factors and their effects on survival rate. MATERIAL AND METHOD: 80 patients with nasopharynx carcinoma who were applied to Karadeniz Technical University School of Medicine, Radiation Oncology clinic and undergone treatment between January –April 1999 were evaluated retrospectively. 51 patients suitable for the criteria were evaluated in terms of their response to treatment, local control, survival rate and prognostic factors. 18 patients were evaluated in terms of p53 expression. Linear Accelerator (LINAC) 6 MV or Co 60 treatment units were used. Median radiotherapy dosage was administered as 66-72 Gy. Concomitant chemotherapy was applied as cisplatin 30 mg/m2 or as cisplatin 100 mg/m2 once in every 21 days. Neoadjuvant chemotherapy was designed as cisplatin regime (2-3 cycles) and nearly one month later, radiotherapy or concomitant radiotherapy was applied. As adjuvant chemotherapy, average 3 cisplatin +5FU regime was administrated. Nearly one week after radiotherapy treatment the patients with T1-T2 were given 3X400 cGy HDR-BRT into nasopharynx at 0.5 cm depth using of a drill. FINDINGS: 70 Gy and more was given to %64.7 (33) of the patients while %35.3 (18) of them were given 66-70 Gy external beam radiotherapy. Concomittant chemoradiotherapy, neoadjuvant chemotherapy, and adjuvan chemotherapy were applied to 35, 16, and 19 patients respectively. At the end of the study, average survival rate was found as 96 months. Survival rates at 2, 5, 10 years were %82.7, %66.4, %53; distant control %82, %77, %61; disease free survival rate %87.8, %87.8, %87.8 respectively. Factors examined for medial survival rate which were found insignificant due to the inadequate number of patients in the groups at multivariate analysis were; age (p= 0.13), sex (p= 0.842), t stage (p= 0.693), n stage (p= 0.880), stage (p=0.805) histopathology (p= 0.752), EKT (p=0.329), RT dose (p= 0.60), P53 (p=0.942) parameters. The same subgroup was analysed for disease free survival, progression free survival, distant metastasis free survival and local control but significant p value was not obtained. RESULTS: 51 patients with nasopharynx carcinoma were evaluated in terms of age, sex, stage, and histopathologically prognostic factors, and 18 patients were examined in terms of P53 positivity and its effect on overall survival, distant metastasis and disease free survival rate but statistically no significant results were found. For significant results more patients are required.