Nasopharyngeal carcinoma natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
If left untreated [[nasopharyngeal carcinoma]] produces few symptoms early in the course of disease. Non-keratinizing nasopharyngeal carcinoma is associated with a 5 year survival rate of 65%. The common complications of nasopharyngeal carcinoma include airway obstruction, [[dysphagia]] and disfigurement of the neck or face. | If left untreated [[nasopharyngeal carcinoma]] produces few symptoms early in the course of the disease. Non-keratinizing nasopharyngeal carcinoma is associated with a 5 year survival rate of 65%. The common complications of nasopharyngeal carcinoma include airway obstruction, [[dysphagia]] and disfigurement of the neck or face. | ||
==Natural History== | ==Natural History== | ||
Line 18: | Line 18: | ||
*[[Hoarseness]] and speaking inability | *[[Hoarseness]] and speaking inability | ||
*[[Metastasis]] | *[[Metastasis]] | ||
Potential complications of [[radiotherapy]] include: | Potential complications of [[radiotherapy]] include:<ref>{{Cite journal | ||
| author = [[A. W. Lee]], [[S. C. Law]], [[S. H. Ng]], [[D. K. Chan]], [[Y. F. Poon]], [[W. Foo]], [[S. Y. Tung]], [[F. K. Cheung]] & [[J. H. Ho]] | |||
| title = Retrospective analysis of nasopharyngeal carcinoma treated during 1976-1985: late complications following megavoltage irradiation | |||
| journal = [[The British journal of radiology]] | |||
| volume = 65 | |||
| issue = 778 | |||
| pages = 918–928 | |||
| year = 1992 | |||
| month = October | |||
| doi = 10.1259/0007-1285-65-778-918 | |||
| pmid = 1422667 | |||
}}</ref><ref>{{Cite journal | |||
| author = [[A. W. Lee]], [[S. H. Ng]], [[J. H. Ho]], [[V. K. Tse]], [[Y. F. Poon]], [[C. C. Tse]], [[G. K. Au]], [[S. K. O]], [[W. H. Lau]] & [[W. W. Foo]] | |||
| title = Clinical diagnosis of late temporal lobe necrosis following radiation therapy for nasopharyngeal carcinoma | |||
| journal = [[Cancer]] | |||
| volume = 61 | |||
| issue = 8 | |||
| pages = 1535–1542 | |||
| year = 1988 | |||
| month = April | |||
| pmid = 3349419 | |||
}}</ref><ref>{{Cite journal | |||
| author = [[A. W. Lee]], [[W. Foo]], [[R. Chappell]], [[J. F. Fowler]], [[W. M. Sze]], [[Y. F. Poon]], [[S. C. Law]], [[S. H. Ng]], [[S. K. O]], [[S. Y. Tung]], [[W. H. Lau]] & [[J. H. Ho]] | |||
| title = Effect of time, dose, and fractionation on temporal lobe necrosis following radiotherapy for nasopharyngeal carcinoma | |||
| journal = [[International journal of radiation oncology, biology, physics]] | |||
| volume = 40 | |||
| issue = 1 | |||
| pages = 35–42 | |||
| year = 1998 | |||
| month = January | |||
| pmid = 9422555 | |||
}}</ref><ref>{{Cite journal | |||
| author = [[Anne W. M. Lee]], [[Dora L. W. Kwong]], [[Sing Fai Leung]], [[Stewart Y. Tung]], [[Wai Man Sze]], [[Jonathan S. T. Sham]], [[Peter M. L. Teo]], [[To Wai Leung]], [[Po Man Wu]], [[Rick Chappell]], [[Lester J. Peters]] & [[John F. Fowler]] | |||
| title = Factors affecting risk of symptomatic temporal lobe necrosis: significance of fractional dose and treatment time | |||
| journal = [[International journal of radiation oncology, biology, physics]] | |||
| volume = 53 | |||
| issue = 1 | |||
| pages = 75–85 | |||
| year = 2002 | |||
| month = May | |||
| pmid = 12007944 | |||
}}</ref><ref>{{Cite journal | |||
| author = [[J. Chong]], [[L. K. Hinckley]] & [[L. E. Ginsberg]] | |||
| title = Masticator space abnormalities associated with mandibular osteoradionecrosis: MR and CT findings in five patients | |||
| journal = [[AJNR. American journal of neuroradiology]] | |||
| volume = 21 | |||
| issue = 1 | |||
| pages = 175–178 | |||
| year = 2000 | |||
| month = January | |||
| pmid = 10669246 | |||
}}</ref><ref name="ChongOng2008">{{cite journal|last1=Chong|first1=V.F.H.|last2=Ong|first2=C.K.|title=Nasopharyngeal carcinoma|journal=European Journal of Radiology|volume=66|issue=3|year=2008|pages=437–447|issn=0720048X|doi=10.1016/j.ejrad.2008.03.029}}</ref> | |||
* Neurologic complications: | * Neurologic complications: | ||
** [[Radiation]] necrosis of the [[temporal lobes]] | ** [[Radiation]] necrosis of the [[temporal lobes]] |
Revision as of 15:01, 16 April 2019
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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
If left untreated nasopharyngeal carcinoma produces few symptoms early in the course of the disease. Non-keratinizing nasopharyngeal carcinoma is associated with a 5 year survival rate of 65%. The common complications of nasopharyngeal carcinoma include airway obstruction, dysphagia and disfigurement of the neck or face.
Natural History
- If left untreated nasopharyngeal carcinoma produces few symptoms early in its course.
- Once the tumor has expanded from its site of origin in the lateral wall of the nasopharynx, it may obstruct the nasal passages and cause nasal discharge or epistaxis.
Complications
Complications of nasopharyngeal carcinoma include:
- Airway obstruction
- Dysphagia
- Neck/ face disfigurement
- Hardening of the skin of the neck
- Hoarseness and speaking inability
- Metastasis
Potential complications of radiotherapy include:[1][2][3][4][5][6]
- Neurologic complications:
- Radiation necrosis of the temporal lobes
- Cranial nerve palsies
- Encephalomyelopathy
- Atrophy and fibrosis of the muscles of mastication
- Non- neurologic complications:
- Atrophy and fibrosis of the muscles of mastication
- Atrophy of salivary glands
- Otologic deficiencies
- Osteoradionecrosis
Prognosis
Non-keratinizing nasopharyngeal carcinoma is associated with a 5 year survival rate of 65%.[7] Prognosis is influenced by tumor type:[8]
- Type I: Keratinizing squamous cell carcinoma - 42% 5 year survival
- Type II: Non-keratinizing squamous cell carcinoma - 65% 5 year survival
- Type III: Undifferentiated carcinoma - 14% 5 year survival
References
- ↑ A. W. Lee, S. C. Law, S. H. Ng, D. K. Chan, Y. F. Poon, W. Foo, S. Y. Tung, F. K. Cheung & J. H. Ho (1992). "Retrospective analysis of nasopharyngeal carcinoma treated during 1976-1985: late complications following megavoltage irradiation". The British journal of radiology. 65 (778): 918–928. doi:10.1259/0007-1285-65-778-918. PMID 1422667. Unknown parameter
|month=
ignored (help) - ↑ A. W. Lee, S. H. Ng, J. H. Ho, V. K. Tse, Y. F. Poon, C. C. Tse, G. K. Au, S. K. O, W. H. Lau & W. W. Foo (1988). "Clinical diagnosis of late temporal lobe necrosis following radiation therapy for nasopharyngeal carcinoma". Cancer. 61 (8): 1535–1542. PMID 3349419. Unknown parameter
|month=
ignored (help) - ↑ A. W. Lee, W. Foo, R. Chappell, J. F. Fowler, W. M. Sze, Y. F. Poon, S. C. Law, S. H. Ng, S. K. O, S. Y. Tung, W. H. Lau & J. H. Ho (1998). "Effect of time, dose, and fractionation on temporal lobe necrosis following radiotherapy for nasopharyngeal carcinoma". International journal of radiation oncology, biology, physics. 40 (1): 35–42. PMID 9422555. Unknown parameter
|month=
ignored (help) - ↑ Anne W. M. Lee, Dora L. W. Kwong, Sing Fai Leung, Stewart Y. Tung, Wai Man Sze, Jonathan S. T. Sham, Peter M. L. Teo, To Wai Leung, Po Man Wu, Rick Chappell, Lester J. Peters & John F. Fowler (2002). "Factors affecting risk of symptomatic temporal lobe necrosis: significance of fractional dose and treatment time". International journal of radiation oncology, biology, physics. 53 (1): 75–85. PMID 12007944. Unknown parameter
|month=
ignored (help) - ↑ J. Chong, L. K. Hinckley & L. E. Ginsberg (2000). "Masticator space abnormalities associated with mandibular osteoradionecrosis: MR and CT findings in five patients". AJNR. American journal of neuroradiology. 21 (1): 175–178. PMID 10669246. Unknown parameter
|month=
ignored (help) - ↑ Chong, V.F.H.; Ong, C.K. (2008). "Nasopharyngeal carcinoma". European Journal of Radiology. 66 (3): 437–447. doi:10.1016/j.ejrad.2008.03.029. ISSN 0720-048X.
- ↑ Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor). Modern Surgical Pathology (2 Volume Set). London: W B Saunders. ISBN 0-7216-7253-1.
- ↑ Treatment and prognosis of nasopharyngeal carcinoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/nasopharyngeal-carcinoma