الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Nasopharyngeal Carcinoma (NPC) is a rare malignancy throughout most of the world, although; it is a leading form of cancer in a few well-defined populations. The present work was carried out to review medical records of all patients diagnosed with Nasopharyngeal Carcinoma and to identify the incidence of cases presenting to Alexandria main university hospital, stand on treatment modalities applied and survival outcome.
To achieve this aim, the present study included 75 patients diagnosed with Nasopharyngeal Carcinoma. Those patients presented to Clinical Oncology and Nuclear Medicine Department, Alexandria Main University Hospital between January 2002 and December 2011. Medical records of the included patients were reviewed. Epidemiological data, clinicopathological data and details of various administered treatment regimens were retrieved and tabulated. Overall survival (OS) and Event free survival (EFS) of patients who were managed at our department were estimated using Kaplan-meier method.
Most of the patients (48%) were between the age of 40-60 years and 8 % of the patients were children below the age of 18 years. Mean age at diagnosis was about 44.48 ± 16.9 years. Males were more commonly involved than females (68% vs. 23%).
The most common symptom at presentation was clinically apparent cervical LNs, nasal blockage, hearing loss, pain, epistaxis and cranial nerve involvement.
Undifferentiated carcinoma (WHO type III) is the most common histopathologic type among patients. Most of patients presented at advanced disease stage (stage III, IV), about 71.8% of patients. Only 5.4% of patients were metastatic at diagnosis.
A wide variety of treatment modalities was applied to studied patients this is due to lack of Institutional based management guidelines and all stages were included in this study. Around 26% of patients were managed by Radiotherapy only. Concomitant Chemoradiotherapy was used in 15.2% of patients .Induction chemotherapy followed Chemoradiotherapy was used in about 17.3% .Chemotherapy only was used in 15% of patients and 3% of patients were managed by supportive treatment.
Chemotherapy was administered in around 66% of patients. Cisplatin-5FU was the most commonly used chemotherapeutic regimen.
Mean value of definitive radiation dose was 58.14 ± 11.56 Gy divided on a mean of 30.0 ± 6.13 fractions using conventional fractionation for 49 patients and one patient with accelerated fractionation. 78% of patients was planned using 2-Dimentional planning, while 22% by 3-Dinemtional Conformal planning. Most of the patients had interruptions during Radiotherapy (91%) with a median delay 4.5 weeks.
Large number of patients who were managed at our hospital lost their follow up (80%) and 15% were alive without disease by the end of the study.
A total of 45 Nasopharyngeal Carcinoma patients were included in survival outcomes analysis. Median OS was about 16.6 months and median EFS was about 15 months, while five years OS and EFS were about 24% and 14% respectively. By the end of the study (144 months) 17.7% patients were still alive but 15.6% were free of disease. Median Time to Progression for patient who developed relapse of disease was 49 months.