Title : Nasopharyngeal carcinoma: A “different” head and neck tumour
Abstract:
As in some other sites of the head and neck, a broad range of tumours can arise in the nasopharynx: epithelial, mesenchymal, lymphoid, and neuro-ectodermal. However, naso-pharyngeal carcinoma (NPC) is the most interesting and intriguing type, because it is a “peculiar” malignancy, and “different” from almost all other head and neck tumours ac-cording to several points of view. In fact, NPC is a unique disease whose aetiology, clinical behaviour, epidemiology, and histopathology are different from those of all other squamous cell carcinomas of the head and neck. The most distinguishing characteristics of this malignancy are the consistent association with Epstein-Barr virus and the striking geographical differences in its incidence. The aim of this narrative review is to analyse the very large number of studies (sometimes contradictory) on NPC.
In the first part, the histopathology,aetiology, epidemiology, clinical behaviour, natural history, diagnostic work up, and staging will be examined.
The second part deals with treatment. Given that radiotherapy (RT) is the treatment of choice for NPC, chemotherapy (CT) has been added to standard RT to improve outcome in high-risk patients, either as an adjuvant, neoadjuvant or concurrent treatment modality with radiation. Surgery plays an important role in rescuing recurrent or persistent disease after primary (CT) RT. A critical analysis of various treatment described in the literature, both for primary cancer and for regional and distant metastases, is presented. The prognostic factors and the final results of the various treatments will also be analysed.
