Indonesian Journal of Cancer
Vol 16, No 1 (2022): March

Re-Irradiation of Recurrent Nasopharyngeal Cancer: A 4-year Follow-up Study of Treatment using 3-Dimensional Conformal Radiotherapy

Samuel Kelvin Ruslim (Department of Radiation Oncology, Abdoel Wahab Sjahranie Hospital, Samarinda)
Selviant Selviant (Department of Otorhinolaryngology, Abdoel Wahab Sjahranie Hospital, Samarinda,)
Aviciena bin Iskandar (Faculty of Medicine, Mulawarman University, Samarinda)
Sielvyana Sie (Abdoel Wahab Sjahranie Hospital, Samarinda)
Agustinus Darmadi Hariyanto (Department of Radiation Oncology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital)
Monika Kencana Dewi (Department of Radiation Oncology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital)



Article Info

Publish Date
01 Apr 2022

Abstract

Introduction: Nasopharyngeal cancer (NPC) is a prevalent diagnosis of head and neck cancers (HNC) in Asia. In Indonesia, it is estimated that there are 12,000 new cases per year. Case Presentation: The author reports a 25-year-old male patient with recurrent NPC. This patient was first diagnosed with NPC stage IVB in 2013 and was treated by chemoradiation. In 2016, he found another mass in his neck. The biopsy result showed the recurrence of the NPC with histopathology of Undifferentiated carcinoma (WHO type III). Re-irradiation was planned, and the patient subsequently received 3D-Conformal Radiotherapy (3D-CRT) at our department. Four years after the completion of re-irradiation, the patient was alive and well with no signs of recurrence but still complained about late toxicities like trismus and fibrotic neck.  Conclusions: In this study, we discuss the use of 3D-CRT in the re-irradiation of NPC with its limitation on obtaining optimum dose sculpture compared to more sophisticated and widely spread modalities like intensity-modulated radiotherapy (IMRT). However, with careful planning, we can still obtain optimum tumor dose, minimize organs at-risk (OAR) dose, and subsequently late toxicities that come after. We hope that this study can bring hope to centers with limited facilities, and we suggest further studies on re-irradiation, especially in OAR dose tolerance guidelines.

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Journal Info

Abbrev

ijoc

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health

Description

Indonesian Journal of Cancer is a peer-reviewed and open-access journal. This journal is published quarterly (in March, June, September, and December) by Dharmais Cancer Hospital - National Cancer Center. Submissions are reviewed under a broad scope of topics relevant to experimental and clinical ...