Oto Rhino Laryngologica Indonesiana
Vol. 53 No. 2 (2023): VOLUME 53, NO. 2 JULY - DECEMBER 2023

Peran radioterapi lokoregional pada kasus karsinoma nasofaring dengan metastasis jauh: laporan serial kasus berbasis bukti

Ika Dewi Mayangsari (Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia)
Muhammad Ade Rahman (Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia)
Marlinda Adham (Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia)
Gregorius Ben Prajogi (Department of Radiation Oncology, Faculty of Medicine, University of Indonesia / Cipto Mangunkusumo Hospital, Jakarta)
Rahmat Cahyanur (Division of Haematology and Oncology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia / Cipto Mangunkusumo Hospital, Jakarta)
Eka Dian Safitri (Clinical Epidemiology and Evidence Based Medicine Unit, Faculty of Medicine, University of Indonesia / Cipto Mangunkusumo Hospital, Jakarta)



Article Info

Publish Date
03 Jan 2024

Abstract

Background: Nasopharyngeal carcinoma (NPC) is a highly metastatic head and neck cancer primarilytreated with platinum-based chemotherapy. The oligometastasis hypothesis proposed by Hellman andWeichselbaum suggested that controlling the primary tumor through locoregional radiotherapy couldsignificantly improve prolonged disease-free survival. Purpose: To evaluate the effectiveness of combining locoregional radiotherapy with chemotherapy for metastatic NPC. Case series report: The first case involved a 57-year-old male with NPC at T4N3M1 (lungs) with partial response to chemotherapy, who then underwent concurrent chemoradiotherapy. However, his condition deteriorated after completing chemoradiation. The second case featured a 56-year-old male with NPC at T4N3M1 (liver), exhibiting partial response to chemotherapy and remaining at a stable condition after concurrent chemoradiotherapy. Method: Using specific keywords based on clinical questions in the PubMed, Cochrane, EBSCOhost, and Proquest databases. Inclusion criteria, exclusion criteria, and critical appraisal were carried out to find relevant studies. Result: Eleven articles were appraised critically based on the Oxford Centre for Evidence-based Medicine (CEBM) worksheet and include the validity, importance, and applicability in clinical scenarios. Conclusion: Metastatic NPC patients had better overall survival outcomes when treated with locoregional radiotherapy and systemic chemotherapy. Predictive factors influencing survival included oligometastasis, locoregional radiotherapy, chemotherapy response, lactate dehydrogenase, C-reactive protein, EBV DNA, total chemotherapy administration, Karnofsky performance score, number of metastatic lesions, and liver metastases. Platinum-based chemotherapy combined with locoregional radiotherapy could be considered as a management approach for cases of oligometastatic NPC.Keywords: nasopharyngeal carcinoma, chemotherapy, metastasis, overall survival, radiotherapy

Copyrights © 2023






Journal Info

Abbrev

orli

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Journal Othorhinolaryngologica Indonesiana is a peer-reviewed and open access journal that focuses on promoting otorhinolaryngology-head and neck surgery that publishes research reports, case reports, and literature reviews, to increase knowledge and updating diagnostics procedurs on ...