Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma (NPC) is an epithelial malignant tumor originating from the mucosa of the nasopharynx, mainly occurring on the top and side walls of the nasopharynx, especially in the pharyngeal crypts. The causes of nasopharyngeal carcinoma include EB virus infection, genetic and environmental factors, and some unhealthy lifestyle habits such as excessive smoking and consumption of pickled foods may also trigger the occurrence of the disease. Cervical lymph node enlargement is often the first symptom. In terms of symptoms, early nasopharyngeal carcinoma often does not cause obvious symptoms. In the advanced stage, symptoms such as tinnitus, hearing loss, nasal congestion, bloody nasal discharge, headache, as well as neck lumps and cranial nerve paralysis may occur. Regarding infectivity, there is no clear evidence of interpersonal transmission for nasopharyngeal carcinoma.

Figure 1. Nasopharyngeal carcinoma. (Yu, Justin, et al. 2021)

Cause of Disease

At present, it is believed that the occurrence of nasopharyngeal carcinoma is mainly related to factors such as EB virus infection, genetics, and environment. At the same time, unhealthy lifestyles can also trigger the occurrence of the disease, such as excessive smoking, consumption of pickled foods, air pollution, etc.

Treatment

Adopting a multidisciplinary and comprehensive treatment model, and developing individualized comprehensive treatment plans in a planned and reasonable manner, can help improve the effectiveness of treatment and the quality of life of nasopharyngeal carcinoma patients. Radiotherapy is the only curative treatment for nasopharyngeal carcinoma, and the addition of chemotherapy and targeted therapy can further improve the therapeutic effect of nasopharyngeal carcinoma.

• Radiotherapy

Nasopharyngeal carcinoma is highly sensitive to radiotherapy, and radiotherapy is its preferred curative treatment method. Early nasopharyngeal carcinoma can be cured by simple radiation therapy, while advanced nasopharyngeal carcinoma usually requires a comprehensive treatment mode of radiation therapy combined with chemotherapy to achieve better therapeutic effects.

• Chemotherapy

Chemotherapy is a systemic chemical drug treatment that primarily uses chemicals to kill cancer cells. According to the different sequential methods of radiotherapy, it can be divided into induction chemotherapy, synchronous chemotherapy, and adjuvant chemotherapy.

• Induction Chemotherapy

For patients with locally advanced nasopharyngeal carcinoma, due to the large size of the tumor at the time of diagnosis, direct synchronous radiotherapy and chemotherapy may not completely eliminate the tumor, and may cause significant damage to surrounding normal tissues. Therefore, induction chemotherapy can be evaluated for 2-3 cycles before synchronous radiotherapy and chemotherapy.

Conclusions

Nasopharyngeal carcinoma is a complex and multifaceted disease with unique epidemiological, clinical, and therapeutic characteristics. While it is a rare cancer in most populations, it is highly prevalent in specific regions, particularly in Southeast Asia and parts of Africa. Advances in treatment, including concurrent chemoradiotherapy and emerging immunotherapies, have significantly improved survival rates for patients.