Neurosurgical interventions for patients with nasopharyngeal carcinoma: a single institution experience
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RESEARCH
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Neurosurgical interventions for patients with nasopharyngeal carcinoma: a single institution experience Ke Sai1,5, Yong-gao Mou1,5, Jing Zeng2,5, Yan-chun Lv3,5, Shao-yan Xi2,5, Su Guan4,5, Xiang-heng Zhang1,5, Jian Wang1,5, Chao Ke1,5, Jian-gui Guo1,5, Yin-sheng Chen1,5 and Zhong-ping Chen1,5*
Abstract Background: Nasopharyngeal carcinoma (NPC) is a frequent head and neck cancer in southern China and Southeast Asia. The majority of NPC patients are managed by radiation oncologists, medical oncologists and head and neck surgeons. Actually, neurosurgical interventions are warranted under specific circumstances. In this article, we described our experience as neurosurgeons in the management of NPC patients. Methods: Medical records of NPC patients who received neurosurgical procedure at Sun Yat-sen University Cancer Center were reviewed. Results: Twenty-seven patients were identified. Among 27 cases, neurosurgical procedures were performed in 18 (66.7%) with radiation-induced temporal necrosis, 2 (7.4%) with radiation-induced sarcoma, 4 (14.8%) with synchronous NPC with primary brain tumors, 2 (7.4%) with recurrent NPC involving skull base, and 1 (3.7%) with metachronous skull eosinophilic granuloma, respectively. The diagnosis is challenging in specific cases and initial misdiagnoses were found in 6 (22.2%) patients. Conclusions: For NPC patients with intracranial or skull lesions, the initial diagnosis can be occasionally difficult because of the presence or a history of NPC and related treatment. Unawareness of these entities can result in misdiagnosis and subsequent improper treatment. Neurosurgical interventions are necessary for the diagnosis and treatment for these patients. Keywords: Nasopharyngeal carcinoma, Radiation-induced temporal necrosis, Radiation-induced sarcoma, Multiple primary tumor
Background Nasopharyngeal carcinoma (NPC) is one of the most prevalent malignancies in southern China and Southeast Asia. In a Chinese endemic area, the incidence rate of NPC reaches as high as 27.2 per 100,000 person-years in men [1]. In addition, NPC is more significantly frequent in Chinese immigrants in the United States [2]. Radiotherapy remains the mainstay treatment for NPC due to the radiosensitivity of the disease. In addition, NPC has been demonstrated to have a high response rate to * Correspondence: [email protected] 1 Department of Neurosurgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Ghuangzhou 510060, China 5 State Key Laboratory of Oncology in South China, Guangzhou, China Full list of author information is available at the end of the article
multiple chemotherapeutic agents. The combination of chemotherapy with radiotherapy results in a decrease in distant metastases and improvement of locoregional control rate as well as overall survival [3]. Moreover, salvage surgery is indicated and beneficial for selected patients with local recurrent disease [4]. Therefore, the majority of patients with NPC are managed by r
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