Nasopharyngeal carcinoma secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]Faizan Sheraz, M.D. [3]

Overview

Secondary prevention measures of nasopharyneal cancer include routine physical examination and imaging at scheduled intervals after treatment. Dental screening and screening for thyroid cancers are recommended among patients who had received radiation therapy to the oral cavity and cervical region, respectively.

Patients treated for nasopharyngeal carcinoma should follow-up for secondary prevention. Follow-up measures are shown in the table below:^[1]^[2]


Follow up	Description

Physical exam	Every 1-3 months during the 1st year after treatment Every 2-6 months during the 2nd year after treatment Every 4-8 months between the 3rd and 5th years after treatment Annually thereafter
Nasoendoscopy	Immediately following radiation therapy
Scanning CT Scan MRI	Scans are performed at routine intervals as follows: Baseline scanning is performed at 3-6 months after treatment, further scans are scheduled based on finding of physical exam and symptoms experienced by the patient Scanning for asymptomatic patients is not recommended
Thyroid hormone testing	Thyroid stimulating hormone testing every 12 months if the neck was exposed to radiation
Dental screening	Only recommended if oral cavity was exposed to radiation

↑ Pfister DG, Ang KK, Brizel DM, Burtness BA, Busse PM, Caudell JJ; et al. (2013). "Head and neck cancers, version 2.2013. Featured updates to the NCCN guidelines". J Natl Compr Canc Netw. 11 (8): 917–23. PMID 23946171.
↑ Chan, A. T. C.; Gregoire, V.; Lefebvre, J.- L.; Licitra, L.; Hui, E. P.; Leung, S. F.; Felip, E. (2012). "Nasopharyngeal cancer: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Annals of Oncology. 23 (suppl 7): vii83–vii85. doi:10.1093/annonc/mds266. ISSN 0923-7534.