Alami Zenab, Bouhafa Touria, Elmazghi Abderrahmane, Hassouni Khalid
Service de Radiothérapie, CHU Hassan II, Faculté de Médecine et de Pharmacie de Fès, Maroc.
Pan Afr Med J. 2018 Oct 10;31:98. doi: 10.11604/pamj.2018.31.98.14951. eCollection 2018.
This study aimed to investigate the epidemiological, clinical, therapeutic and evolutionary features of undifferentiated carcinoma of the nasopharynx in adults. We conducted a retrospective cohort study of 163 patients aged 17 years old and over, treated for non metastatic undifferentiated carcinoma of the nasopharynx. The average age of our patients was 46,5 years, with a sex-ratio of 1.7; 35.57% of patients had locally advanced tumors (T3-T4) and 52.27% had advanced regional lymph nodes involvement (N2-N3). Neoadjuvante chemotherapy was performed in 77% of patients and 93.8% of patients underwent concomitant radiochemotherapy. After a mean follow-up interval of 40.8 months overall survival was 92.9% and relapse-free survival (RFS) was 78.9%. Relapse-free survival was caculated according to different prognostic factors, revealing a statistically significant difference based on lymph nodes involvement; three-year RFS rates were 88%, 82.6%, 80.8% and 61.5% in patients with tumor classified as N0, N1, N2 and N3, respectively (p = 0.02). Nasopharyngeal cancer is a complex disease, but progress has been made thanks to advances in radiotherapy and molecular biology. Concomitant radiochemotherapy is the therapeutic standard for patients with clinical stage greater than or equal to T2, or greater than or equal to N1. The innovative techniques in radiation therapy appear promising and they could reduce late toxicity while ensuring an excellent local control rate.
本研究旨在调查成人未分化鼻咽癌的流行病学、临床、治疗及演变特征。我们对163例年龄在17岁及以上、接受非转移性未分化鼻咽癌治疗的患者进行了一项回顾性队列研究。我们患者的平均年龄为46.5岁，性别比为1.7；35.57%的患者患有局部晚期肿瘤（T3-T4），52.27%的患者有区域淋巴结转移（N2-N3）。77%的患者接受了新辅助化疗，93.8%的患者接受了同步放化疗。平均随访40.8个月后，总生存率为92.9%，无复发生存率（RFS）为78.9%。根据不同的预后因素计算无复发生存率，结果显示基于淋巴结转移情况存在统计学显著差异；肿瘤分类为N0、N1、N2和N3的患者三年无复发生存率分别为88%、82.6%、80.8%和61.5%（p = 0.02）。鼻咽癌是一种复杂的疾病，但由于放疗和分子生物学的进展已取得了进步。同步放化疗是临床分期大于或等于T2或大于或等于N1患者的治疗标准。放射治疗中的创新技术似乎很有前景，它们可以降低晚期毒性，同时确保出色的局部控制率。
