G.Z. Xu

Nasopharyngeal mucoepidermoid carcinoma: A review of 13 cases

Nasopharyngeal mucoepidermoid carcinoma (MEC) is an extremely rare entity. To date, there is little published about its clinical characteristics and treatment outcomes. Between 1997 and 2009, 13 cases of MEC were confirmed and treated at the department of Radiation Oncology, Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC). Nasal obstruction, bleeding and hearing loss were the most common presentations, whereas, neck mass, headache and cranial nerve palsy were uncommon. Tumors remained stable after either primary radiation therapy or post-operative radiation therapy for the residual, though the majority of them were high or high-intermediate grade tumors. Five patients, who received either primary surgery or salvage surgery, had positive surgical margins, however, all are alive with stable disease except one old patient died of heart failure. The overall median survival of our patients was 43months, ranging from 8 to 80months. Based on the present results, we recommend that primary surgery should be the standard of care for all non-metastatic tumors regardless of histopathologic grade, and post-operative radiation therapy should be considered under the circumstances of positive surgical margins, macroscopic residual tumors, and high grade carcinomas.

Primary salivary gland-type carcinomas of the nasopharynx: Prognostic factors and outcome

Primary salivary gland-type carcinomas of the nasopharynx (SNPC) are a rare malignancy with diverse clinical behaviour and different prognoses. Previous studies have reported on limited patient populations, and few long-term studies have outlined outcomes and prognostic factors. Controversy exists regarding the treatment policy for SNPC. The aim of this study was to define management approaches, therapeutic outcomes, and prognostic factors for SNPC. The medical records of 54 patients with SNPC at one institution between 1963 and 2006 were reviewed. Patient records were analysed for management approaches, outcomes, and prognostic factors. After a median follow-up of 61.3 (1.8-245.2) months, the 2-, and 5-year overall survival rates (OS), loco-regional failure free survival rates (LRFFS) and distant failure free survival rates (DFFS) were 84.6% and 61.3%, 74.4% and 55.4%, and 92.0% and 70.0%, respectively. Multivariate analyses indicated that lymph node metastases, date of treatment, and surgical treatment were independent factors for DFFS, whereas histological subtypes and distant metastases were independent factors affecting OS. The optimal treatment policy for patients with SNPC might be surgery plus radiotherapy.

Management of Nasopharyngeal Adenoid Cystic Carcinoma

PURPOSE Nasopharyngeal adenoid cystic carcinomas (NACCs) are rare. No clear consensus is available regarding clinical characteristics and management approaches. The aim of this study was to summarize the clinical characteristics and evaluate the management approaches of NACC. MATERIALS AND METHODS The experience of 1 institution with this tumor and the outcomes of treatment were examined. The medical records of 36 patients with NACC at 1 institution from 1963 through 2006 were reviewed. RESULTS After a median follow-up of 65.8 months (1.8 to 245.2 mo), the 5- and 10-year overall survival, locoregional failure-free survival, and distant metastasis failure-free survival rates were 70.2% and 31.6%, 63.4% and 49.1%, and 65.0% and 59.6%, respectively. No significant differences were found in locoregional failure-free survival, distant metastasis failure-free survival, or overall survival rates between the group that received radiotherapy alone and the group that received combined modality therapy (radiotherapy plus surgery or surgery plus radiotherapy). CONCLUSIONS NACC is a malignancy with a generally favorable prognosis. Radiotherapy alone or a combined modality therapy (radiotherapy plus surgery or surgery plus radiotherapy) is effective in the treatment of NACC.

Mastoid recurrence after radiotherapy for nasopharyngeal carcinoma: Two case studies

The mastoid is a rare site of nasopharyngeal carcinoma recurrence after radiotherapy, and no relevant reports are currently in the literature.