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All Journal Paediatrica Indonesiana International Journal of Nasopharyngeal Carcinoma
Namira Kesuma Jelita
Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
Health Professions Medicine & Pharmacology

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Epstein-Barr DNA in advanced pediatric nasopharyngeal cancer Marlinda Adham; Namira Kesuma Jelita; Djajadiman Gatot; Soehartati Argadikoesoema Gondhowiardjo; Lisnawati Rachmadi; Astrid E Greijer; I Bing Tan; Jaap M Middeldorp
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.261-70

Abstract

Background Studies suggest that the most common type of nasopharyngeal carcinoma (NPC) is WHO-3, which is strongly associated with Epstein-Barr virus (EBV). Objective To assess NPC patient characteristics in a national general referral hospital in Indonesia, with regards to EBV DNA load and treatment response. Methods Twenty-three pediatric patients diagnosed with NPC were included in the study. Data collected were history, physical examination, tissue biopsy, CT scan, staging and EBV DNA load from nasopharyngeal (NP) brushing as well as blood specimens. The NP brushing, blood specimens and CT scan evaluations were done two months post-treatment. Results Pediatric patients with symptoms such as blood tinged secretion, lymph node enlargement, and nasal congestion were more likely to have higher EBV DNA loads in their NP brushings (P<0.05) (including T3 and higher). Despite significant reduction of EBV DNA load in NP brushing post-treatment, it was not associated with treatment response, as evaluated by CT scan. Conclusion Higher DNA load from NP brushings is associated with a higher tumor stage. Larger sample size and follow-up data are needed to assess the usefulness of EBV DNA load assessment in pediatric patients.
Current Outcome of Adjuvant Platinum-Based Chemotherapy for Nasopharyngeal Carcinoma: A Systematic Review Namira Kesuma Jelita; Marlinda Adham; Saffanah Zahra
INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA Vol. 2 No. 03 (2020): International Journal of Nasopharyngeal Carcinoma
Publisher : TALENTA PUBLISHER

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/ijnpc.v2i03.4301

Abstract

Introduction: Indonesia are among the top 5 countries with highest prevalence of NPC with a meta-analysis from 2018 stating prevalence as high as 13.084 cases. According to the latest guideline published by National Comprehensive Cancer Network (NCCN) in 2018. The main treatment for NPC remain radiotherapy, chemotherapy, and surgery. Induction or adjuvant chemotherapy place in treatment are still uncertain because variety of results from multiple clinical trial. Discussion: This review evaluates the current outcome of patient undergoing chemoradiotherapy with or without adjuvant chemotherapy and its usage in nasopharyngeal carcinoma patient. Search on online databases are performed with keywords including “nasopharyngeal carcinoma”, “chemotherapy”, “adjuvant” and “outcome” along with their synonyms. Studies in English from 2014-2019 are included.  Quality assessment were done with Newcastle Ottawa Scale for Cohort studies and with CEBM for Randomized Controlled Trial Studies. Risk of bias assessed using Cochrane Method. A total of 7 studies were included in the final review with 1 RCT and 6 Cohort study. Most study have no significance in overall survival, progressive disease or distant metastasis free time, but differ in high stage and high risk patient. Three studies included toxicity as an outcome with adjuvant toxicity outweigh the need to add another round of chemotherapy. Conclusion: Adjuvant chemotherapy is believed to be necessary in eliminating residual cancer cells but current studies shows little improvement in overall survival and sometimes unbearable toxicities.
Co-Authors Astrid E Greijer Djajadiman Gatot I Bing Tan Jaap M Middeldorp Lisnawati Rachmadi Marlinda Adham Saffanah Zahra Soehartati Argadikoesoema Gondhowiardjo