Nasopharyngeal carcinoma in Saudi Arabia: A retrospective study of 166 cases treated with curative intent

• Published in: International journal of radiation oncology, biology, physics Vol. 15; no. 5; pp. 1119 - 1127
• Main Authors: Laramore, G.E, Clubs, B, Quick, C, Amer, M.H, Ali, M, Greer, W, Mahboubi, E, El-Senoussi, M, Schultz, H, El-Akkad, S.M
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.1988; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cancer in Saudi Arabia; Carcinoma - epidemiology; Carcinoma - radiotherapy; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - radiotherapy; Female; Humans; Male; Medical sciences; Middle Aged; Nasopharyngeal carcinoma; Nasopharyngeal Neoplasms - epidemiology; Nasopharyngeal Neoplasms - radiotherapy; Otorhinolaryngology. Stomatology; Prognosis; Retrospective Studies; Saudi Arabia; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Saudi Arabia; Nasopharyngeal carcinoma; Cancer in Saudi Arabia; Saudi Arabia; ENT disease; Tumor; Nasopharynx; Radiotherapy; Asia
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/0360-3016(88)90193-9

A retrospective review was performed of the medical records of 166 adult patients with biopsy-proven carcinomas of the nasopharynx treated with curative intent at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. All patients were treated between June 1975 and December 1985 using megavoltage therapy equipment. Most patients presented with advanced nodal disease: 23 patients (13.9%) were N 0, 16 patients (9.6%) were N 1, 29 patients (17.5%) were N 2, and 98 patients (59%) were N 3. The overwhelming majority of patients had nonkeratinizing lesions ( 158 166 ). At the time of analysis, mean follow-up time was 24.2 months (range 2–108). Actuarial curves are presented for local/regional control as a function of T-stage and N-stage and for survival and time to development of distant metastases as a function of N-stage. At 4 years local/regional control was 70% for T 1 lesions, 59% for T 2 lesions, 30% for T 3 lesions, and 35% for T 4 lesions. There was little correlation between local/regional control and N-stage being about 50% at 4 years for all nodal subgroups. Only six patients exhibited an isolated first failure in the regional nodes alone, whereas 60 patients failed initially at the primary site (either alone or in conjunction with a simultaneous nodal failure). The development of distant metastases correlated to some extent with nodal disease ranging from 20% at 4 years for T 1 T 2 N 0 patients to 70% for patients who initially presented with N 3 disease. Survival data was more difficult to obtain due to cultural biases in a medically unsophisticated patient population. True survival curves are bounded by calculating actuarial curves in two ways: death as the failure endpoint and death plus lost-with-active-disease as failure endpoints. In terms of the latter curves, at 4 years “survival” ranged from 39% for patients with T 1 T 2 N 0 lesions to 23% for patients with N 3 lesions.