5725-Article Text-20053-1-10-20210320
5725-Article Text-20053-1-10-20210320
5725-Article Text-20053-1-10-20210320
International Journal of
NASOPHARYNGEAL CARCINOMA
Journal homepage: https://talenta.usu.ac.id/IJNPC
1. CASE REPORT left sphenoid and ethmoid sinuses, the left sella dorsum and suspiciously
extends to the left cavernous sinus. Abdominal ultrasound examination
A 57-year-old man was referred to RSUP Dr. Mohammad Hoesin showed no visible metastatic nodules. Based on medical history, physical
Palembang in September 2020. The patient presented with complaints of examination, and radiology imaging, nasopharyngeal carcinoma was
obstruction in both noses (especially in the left nose), headache, nosebleeds, obtained. Histopathology results showed a differentiated non keratinizing
headache, runny nose with yellowish white discharge, there is no decrease squamous cell carcinoma in the nasopharynx. Patient diagnosed with NPC
in smelling, and no lumps on both sides of the neck. The patient also WHO II stage III (T3N0M0) and planned 6 cycles of chemotherapy with
complained of reduced hearing in the left ear with no history of discharge carboplatin and docetaxel regimen every 3 weeks per cycles, chemotherapy
from the ear. The complaints have been felt since 5 months ago. He had a starts from October 2020 to February 2021. On February 13th, 2021, during
previous history of smoking and drinking alcohol. his last cycles, his blood result showed that he was anemic (Hb 8.6 gr/dl)
On physical examination, the general condition was good. Patient and leukopenia (WBC 2890 mcl). Patient administered to the hospital and
was full alert, blood pressure was normal at 120/80 mmHg, pulse was 82 we treated the patient with transfusion with 400 cc of PRC and filgrastim
x/minute, temperature and breathing within normal limits, and there is no injection. The patient showed response after the treatment and continued
sign of difficulty in breathing. Neck examination showed no lumps or with cycle 6th of chemotherapy. The patient showed good condition after
enlarged lymph nodes in both necks. No abnormalities were found on ears undergoing chemotherapy and was discharged and prescribed with oral
and throat examination. Furthermore, the patient underwent an anterior medicine for home treatment. The patient has been undergoing six cycle of
rhinoscopy, which showed a mass invading both of nasal cavity with lots of chemotherapy and showed good condition, despite experiences occasional
serous secretion. The mass looked brittle and bleeding easily. We performed nausea and malaise.
a tele nasoendoscopy examination, showing a mass in the nasopharynx that
extends into the right and left nasal cavity. We performed a biopsy in the
nasopharynx.
Copyright © International Journal of Nasopharyngeal Carcinoma Published by Talenta Publisher, ISSN: 2656-9027 e-ISSN: 2656-9035 DOI: 10.32734/ijnpc.v3i01.5725 25
International Journal of Nasopharyngeal Carcinoma (IJNPC) Vol. 03, No. 01, March, 2021 | 25-27
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International Journal of Nasopharyngeal Carcinoma (IJNPC) Vol. 03, No. 01, March, 2021 | 25-27
treatment of locoregional advanced stage NPC [16]. The cisplatin group is [9] Chua ML, Wee JT, Hui EP, Chan AT. Nasopharyngeal carcinoma. The
more toxic for renal, has a side effect of leukopenia and anemia, but in the Lancet. 2016 Mar 5;387(10022):1012-24. DOI:
carboplatin group, it's more in thrombocytopenia as a side effect. The 3-year https://doi.org/10.1016/S0140-6736(15)00055-0
disease free survival rates were higher for the cisplatin group than the [10] Ch Chen YP, Chan AT, Le QT, Blanchard P, Sun Y, Ma J.
carboplatin group. The 3-year overall survival rates were 77.7% for cisplatin Nasopharyngeal carcinoma. The Lancet. 2019 Jul 6;394(10192):64-
group and 79.2% for carboplatin groups. Carboplatin showed similar 80. DOI: https://doi.org/10.1016/S0140-6736(19)30956-0
[11] David G, Sharon S, Douglas A. National Comprehensive Cancer
efficacy with cisplatin and have a better tolerability and could be used as an
Network (NCCN) Guidelines Head and Neck Cancers Versions 1.
alternative regimen [17]. 2021. P 37-42
From this case, the results of nasopharyngeal CT scan after [12] Bhattacharyya T, Babu G, Kainickal CT. Current role of chemotherapy
chemoradiotherapy revealed mass in the left nasopharynx extending into the in nonmetastatic nasopharyngeal cancer. Journal of oncology. 2018
left parapharyngeal space and erosion of the left pterygoid plate. Compared to Oct 1;2018.. DOI. https://doi.org/10.1155/2018/3725837
the CT scan on June 20th, 2020, there is no longer any visible expansion of the [13] Mané M, Benkhaled S, Dragan T, Paesmans M, Beauvois S, Lalami Y,
mass to the left nasal cavity, left masticator space, left sphenoidalis and left Szturz P, Gaye PM, Vermorken JB, Van Gestel D. Meta‐Analysis on
ethmoidalis. The patient experiences a good response. Assessment of the Induction Chemotherapy in Locally Advanced Nasopharyngeal
results of treatment with chemotherapy, either alone or in combination with Carcinoma. The oncologist. 2021 Jan;26(1):e130-41.. DOI:
surgery or radiotherapy, is usually done after 3-4 weeks. Complete response is https://doi.org/10.1002/ONCO.13520. Epub 2020 Oct 1
said when all tumors disappear for a period of at least 4 weeks. Head and neck [14] Xu C, Zhang S, Li WF, Chen L, Mao YP, Guo Y, Liu Q, Ma J, Tang
CT scan are diagnostic modalities for follow-up after NPC therapy. The LL. Selection and validation of induction chemotherapy beneficiaries
sensitivity and specificity of CT scan after treatment were 67% and 32%. among patients with T3N0, T3N1, T4N0 nasopharyngeal carcinoma
Imaging to assess recurrence is performed in between 6 months [12]. using Epstein-Barr virus DNA: a joint analysis of real-world and
clinical trial data. Frontiers in oncology. 2019 Nov 29;9:1343. DOI:
https://doi.org/10.3389/fonc.2019.01343. eCollection 2019.
[15] Liao JF, Zhang Q, Du XJ, Lan M, Liu S, Xia YF, Cai XY, Luo W.
Concurrent chemoradiotherapy with weekly docetaxel versus
cisplatin in the treatment of locoregionally advanced
nasopharyngeal carcinoma: a propensity score‐matched analysis.
Cancer Communications. 2019 Dec;39(1):1-1. DOI:
https://doi.org/10.1186/s40880-019-0380-x
[16] Chitapanarux I, Lorvidhaya V, Kamnerdsupaphon P, Sumitsawan Y,
Tharavichitkul E, Sukthomya V, Ford J. Chemoradiation comparing
cisplatin versus carboplatin in locally advanced nasopharyngeal
cancer: randomised, non-inferiority, open trial. European journal of
cancer. 2007 Jun 1;43(9):1399-406. DOI:
https://doi.org/10.1016/j.ejca.2007.03.022
[17] Ngaimphaiboon N, Dechaphunkul A, Danchaivijitr P, Jiratrachu R,
Picture 5. NCCN Guidelines Version 1.2021 Cancer of the Nasopharynx [11]. Dechaphunkul T, Sookthon C, Jiarpinitnun C, Paoin C,
Setakornnukul J, Suktitipat B, Pattaranutaporn P. Comparison of
3. CONCLUSION 3-weekly cisplatin versus 3-weekly carboplatin in patients with
locally advanced nasopharyngeal carcinoma receiving concurrent
Chemotherapy management in this patient is similar to the
chemoradiotherapy: A multicentre analysis. DOI:
management of nasopharyngeal carcinoma and has given a good response
https://doi.org/10.1200/JCO.2017.35.15_suppl.6006cita
to the patient. One of the standard treatment options for LA-NPC is to add
IC to CCRT for NPC therapy. Carboplatin and docetaxel could be used as
an alternative regimen and showed a similar efficacy with other
chemotherapy regimens and have a better tolerability.
REFERENCES
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