Krebswissenschaft und -therapie

Diagnostic, Therapeutic and Evolutionary Characteristics of Nasopharyngeal Cancer in Morocco

Abstract

Elamin Marnouche, Mohammed Elmarjany, Rachid Razine, Abdelhak Maghous, Issam Lalya, Khalid Andaloussi, Amine Bazine, Noha Zaghba, Khalid Hadadi, Hassan Sifat and Hamid Mansouri

Background: Nasopharyngeal carcinoma (NPC) is a radiosensitive and radio curable cancer, the radiation therapy (RT) is the mainstay of treatment with significant improvement in survival of patients. The aim of this study was to report the experience of Military Hospital Mohamed V in the management of NPC and their results.

Materials and methods: 83 no metastatic NPC patients managed at the radiotherapy department of Military Hospital Mohammed V of Rabat in Morocco, between January 2005 and December 2009, were included for investigation of their demographic, histological, therapeutic and follow-up characteristics. Statistical analysis of the data was carried out by the SPSS for Windows.

Results: The mean age was 44.5 ± 12.5 years with sex ratio 4:1. At diagnosis, rhinologic symptoms represented the most common clinical presentation, reported by 56 (67, 5%) patients. Almost ninety percent (n=74) of patients presented UCNT histology. Most of the patients (85.5%) presented a locally advanced disease; stage III and IV. Therefore, forty patients (48.2%) were treated by concurrent chemoradiotherapy and 35 patients (42.2%) received induction chemotherapy. With a mean follow up of 70 ± 32 months, twenty nine patients (34.9%) died, 6 (7.2%) presented local or locoregional relapse. While 11 (13.2%) patients presented distant recurrences. The five years overall survival (OS) was 68% ranging from 91% for both stage I and II, 79.3% for stage III to 40% for stage IV. The five years disease free survival (DFS) was 81.1%, whereas distant failure free survival (DFFS) was 84.1%. In multivariate analysis, the disease stage according to the seventh edition of the AJCC system was an independent prognostic factor.

Conclusion: Our outcomes in NPC are similar to the literature. Patients’ survival is directly impacted by the disease staging which is the most important prognostic factor. We hope to improve these results with the recent acquisition of volumetric-modulated arc therapy machines.