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==Medical Therapy==
==Medical Therapy==
The mainstay of therapy for nasopharyngeal carcinoma is [[external beam radiotherapy]].
The mainstay of therapy for nasopharyngeal carcinoma is [[external beam radiotherapy]].<ref name="PastorLopez Pousa2017">{{cite journal|last1=Pastor|first1=M.|last2=Lopez Pousa|first2=A.|last3=del Barco|first3=E.|last4=Perez Segura|first4=P.|last5=Astorga|first5=B. Gonzalez|last6=Castelo|first6=B.|last7=Bonfill|first7=T.|last8=Martinez Trufero|first8=J.|last9=Grau|first9=J. Jose|last10=Mesia|first10=R.|title=SEOM clinical guideline in nasopharynx cancer (2017)|journal=Clinical and Translational Oncology|volume=20|issue=1|year=2017|pages=84–88|issn=1699-048X|doi=10.1007/s12094-017-1777-0}}</ref>
===Treatment according to Stages===
 
===Treatment according to Stages===<ref name="LeeNg2014">{{cite journal|last1=Lee|first1=Anne W.M.|last2=Ng|first2=Wai Tong|last3=Chan|first3=Lucy L.K.|last4=Hung|first4=Wai Man|last5=Chan|first5=Connie C.C.|last6=Sze|first6=Henry C.K.|last7=Chan|first7=Oscar S.H.|last8=Chang|first8=Amy T.Y.|last9=Yeung|first9=Rebecca M.W.|title=Evolution of treatment for nasopharyngeal cancer – Success and setback in the intensity-modulated radiotherapy era|journal=Radiotherapy and Oncology|volume=110|issue=3|year=2014|pages=377–384|issn=01678140|doi=10.1016/j.radonc.2014.02.003}}</ref><ref name="ChuaMa2006">{{cite journal|last1=Chua|first1=Daniel T.T.|last2=Ma|first2=Jun|last3=Sham|first3=Jonathan S.T.|last4=Mai|first4=Hai-Qiang|last5=Choy|first5=Damon T.K.|last6=Hong|first6=Ming-Huang|last7=Lu|first7=Tai-Xiang|last8=Au|first8=Gordon K.H.|last9=Min|first9=Hua-Qing|title=Improvement of survival after addition of induction chemotherapy to radiotherapy in patients with early-stage nasopharyngeal carcinoma: Subgroup analysis of two Phase III trials|journal=International Journal of Radiation Oncology*Biology*Physics|volume=65|issue=5|year=2006|pages=1300–1306|issn=03603016|doi=10.1016/j.ijrobp.2006.02.016}}</ref><ref name="Ribassin-MajedMarguet2017">{{cite journal|last1=Ribassin-Majed|first1=Laureen|last2=Marguet|first2=Sophie|last3=Lee|first3=Anne W.M.|last4=Ng|first4=Wai Tong|last5=Ma|first5=Jun|last6=Chan|first6=Anthony T.C.|last7=Huang|first7=Pei-Yu|last8=Zhu|first8=Guopei|last9=Chua|first9=Daniel T.T.|last10=Chen|first10=Yong|last11=Mai|first11=Hai-Qiang|last12=Kwong|first12=Dora L.W.|last13=Cheah|first13=Shie-Lee|last14=Moon|first14=James|last15=Tung|first15=Yuk|last16=Chi|first16=Kwan-Hwa|last17=Fountzilas|first17=George|last18=Bourhis|first18=Jean|last19=Pignon|first19=Jean Pierre|last20=Blanchard|first20=Pierre|title=What Is the Best Treatment of Locally Advanced Nasopharyngeal Carcinoma? An Individual Patient Data Network Meta-Analysis|journal=Journal of Clinical Oncology|volume=35|issue=5|year=2017|pages=498–505|issn=0732-183X|doi=10.1200/JCO.2016.67.4119}}</ref>
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*[[Pharmacologic]] [[medical]] therapies for nasopharyngeal carcinoma include [[Cisplatin]] and 5-[[Fluorouracil (injection)|Fluorouracil]].
*[[Pharmacologic]] [[medical]] therapies for nasopharyngeal carcinoma include [[Cisplatin]] and 5-[[Fluorouracil (injection)|Fluorouracil]].


* '''Cisplatin:'''
* '''Cisplatin:'''<ref name="DeckerDrelichman1983">{{cite journal|last1=Decker|first1=David A.|last2=Drelichman|first2=Anibal|last3=Al-Sarraf|first3=Muhyi|last4=Crissman|first4=John|last5=Reed|first5=Melvin L.|title=Chemotherapy for nasopharyngeal carcinoma a ten-year experience|journal=Cancer|volume=52|issue=4|year=1983|pages=602–605|issn=0008-543X|doi=10.1002/1097-0142(19830815)52:4<602::AID-CNCR2820520404>3.0.CO;2-6}}</ref><ref>{{Cite journal
| author = [[K. Al-Kourainy]], [[J. Crissman]], [[J. Ensley]], [[J. Kish]], [[J. Kelly]] & [[M. Al-Sarraf]]
| title = Excellent response to cis-platinum-based chemotherapy in patients with recurrent or previously untreated advanced nasopharyngeal carcinoma
| journal = [[American journal of clinical oncology]]
| volume = 11
| issue = 4
| pages = 427–430
| year = 1988
| month = August
| pmid = 2457306
}}</ref>
** Preferred regimen: 80-100 mg/m<sup>2</sup>  slow [[Intravenous therapy|IV]] with enough [[hydration]]. Repeat every 3 weeks.
** Preferred regimen: 80-100 mg/m<sup>2</sup>  slow [[Intravenous therapy|IV]] with enough [[hydration]]. Repeat every 3 weeks.
** [[Contraindications]]:
** [[Contraindications]]:
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'''Note (2):''' [[Antiemetic|Anti-emetic]] treatment should be done in all [[patients]].
'''Note (2):''' [[Antiemetic|Anti-emetic]] treatment should be done in all [[patients]].


* '''5-Fluorouracil:'''
* '''5-Fluorouracil:'''<ref name="Al-Sarraf1987">{{cite journal|last1=Al-Sarraf|first1=Muhyi|title=Chemotherapeutic management of head and neck cancer|journal=Cancer and Metastasis Review|volume=6|issue=3|year=1987|pages=181–198|issn=0167-7659|doi=10.1007/BF00144263}}</ref><ref>{{Cite journal
| author = [[M. Al-Sarraf]]
| title = Head and neck cancer: chemotherapy concepts
| journal = [[Seminars in oncology]]
| volume = 15
| issue = 1
| pages = 70–85
| year = 1988
| month = February
| pmid = 3278391
}}</ref>
** Preferred regimen: 1000 mg/m<sup>2</sup>/day [[Intravenous therapy|IV]] [[infusion]] for 4-5 days and repeated every 3 weeks.
** Preferred regimen: 1000 mg/m<sup>2</sup>/day [[Intravenous therapy|IV]] [[infusion]] for 4-5 days and repeated every 3 weeks.
** [[Contraindications]]:  
** [[Contraindications]]:  
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'''Note (2):''' Using this drug in familial pyrimidenemia [[patients]] can cause fatal [[neurotoxicity]].
'''Note (2):''' Using this drug in familial pyrimidenemia [[patients]] can cause fatal [[neurotoxicity]].


**
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 18:44, 18 March 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]Faizan Sheraz, M.D. [3]

Overview

The mainstay of therapy for nasopharyngeal carcinoma is external beam radiotherapy, supplemented in some cases with chemotherapy.

Medical Therapy

The mainstay of therapy for nasopharyngeal carcinoma is external beam radiotherapy.[1]

===Treatment according to Stages===[2][3][4]

Stage Treatment

Stage 1

Stage 2

Stage 3

Stage 4

Medical Therapy

Note (1): Urine output should be maintain more than 100-150 ml/ hr.

Note (2): Anti-emetic treatment should be done in all patients.

Note (1): In patients with liver diseases dose reduction should be considered.

Note (2): Using this drug in familial pyrimidenemia patients can cause fatal neurotoxicity.

References

  1. ↑ Pastor, M.; Lopez Pousa, A.; del Barco, E.; Perez Segura, P.; Astorga, B. Gonzalez; Castelo, B.; Bonfill, T.; Martinez Trufero, J.; Grau, J. Jose; Mesia, R. (2017). "SEOM clinical guideline in nasopharynx cancer (2017)". Clinical and Translational Oncology. 20 (1): 84–88. doi:10.1007/s12094-017-1777-0. ISSN 1699-048X.
  2. ↑ Lee, Anne W.M.; Ng, Wai Tong; Chan, Lucy L.K.; Hung, Wai Man; Chan, Connie C.C.; Sze, Henry C.K.; Chan, Oscar S.H.; Chang, Amy T.Y.; Yeung, Rebecca M.W. (2014). "Evolution of treatment for nasopharyngeal cancer – Success and setback in the intensity-modulated radiotherapy era". Radiotherapy and Oncology. 110 (3): 377–384. doi:10.1016/j.radonc.2014.02.003. ISSN 0167-8140.
  3. ↑ Chua, Daniel T.T.; Ma, Jun; Sham, Jonathan S.T.; Mai, Hai-Qiang; Choy, Damon T.K.; Hong, Ming-Huang; Lu, Tai-Xiang; Au, Gordon K.H.; Min, Hua-Qing (2006). "Improvement of survival after addition of induction chemotherapy to radiotherapy in patients with early-stage nasopharyngeal carcinoma: Subgroup analysis of two Phase III trials". International Journal of Radiation Oncology*Biology*Physics. 65 (5): 1300–1306. doi:10.1016/j.ijrobp.2006.02.016. ISSN 0360-3016.
  4. ↑ Ribassin-Majed, Laureen; Marguet, Sophie; Lee, Anne W.M.; Ng, Wai Tong; Ma, Jun; Chan, Anthony T.C.; Huang, Pei-Yu; Zhu, Guopei; Chua, Daniel T.T.; Chen, Yong; Mai, Hai-Qiang; Kwong, Dora L.W.; Cheah, Shie-Lee; Moon, James; Tung, Yuk; Chi, Kwan-Hwa; Fountzilas, George; Bourhis, Jean; Pignon, Jean Pierre; Blanchard, Pierre (2017). "What Is the Best Treatment of Locally Advanced Nasopharyngeal Carcinoma? An Individual Patient Data Network Meta-Analysis". Journal of Clinical Oncology. 35 (5): 498–505. doi:10.1200/JCO.2016.67.4119. ISSN 0732-183X.
  5. ↑ Decker, David A.; Drelichman, Anibal; Al-Sarraf, Muhyi; Crissman, John; Reed, Melvin L. (1983). "Chemotherapy for nasopharyngeal carcinoma a ten-year experience". Cancer. 52 (4): 602–605. doi:10.1002/1097-0142(19830815)52:4<602::AID-CNCR2820520404>3.0.CO;2-6. ISSN 0008-543X.
  6. ↑ K. Al-Kourainy, J. Crissman, J. Ensley, J. Kish, J. Kelly & M. Al-Sarraf (1988). "Excellent response to cis-platinum-based chemotherapy in patients with recurrent or previously untreated advanced nasopharyngeal carcinoma". American journal of clinical oncology. 11 (4): 427–430. PMID 2457306. Unknown parameter |month= ignored (help)
  7. ↑ Al-Sarraf, Muhyi (1987). "Chemotherapeutic management of head and neck cancer". Cancer and Metastasis Review. 6 (3): 181–198. doi:10.1007/BF00144263. ISSN 0167-7659.
  8. ↑ M. Al-Sarraf (1988). "Head and neck cancer: chemotherapy concepts". Seminars in oncology. 15 (1): 70–85. PMID 3278391. Unknown parameter |month= ignored (help)

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