• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2653-2657
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• 2015

Nasopharyngeal carcinoma (NPC) is the second most common neoplasm of head and neck in Tunisia. The distribution is bimodal with a first period occurrence between 15 and 20 years old and a second peak at around 50 years of age. Undifferentiated carcinoma of nasopharynx type III (UCNT) is the predominant histological type (93.4%). Data of cancer registry of North Tunisia confirmed that it is an intermediate risk area for NPC with overall ASRs of 3.6 and 1.6/100,000 respectively in males and females. This study aimed to present the evolution of incidence rate of nasopharyngeal carcinoma over a period of 12 years (1994-2006). Data of cancer registry of North Tunisia (NTCR), covering half of the Tunisian population, were used to determine evolution of NPC incidence, calculated by 5 year periods. The estimated annual percentage change (EAPC) was used as an estimate of the trend. To best summarize the behavior or the data trend across years, we used a join-point regression program. Between 1994 and 2006, we observed negative annual average change of standardized incidence in men and women (-3.3%and -2.7%) also for the standardized incidences which showed a rather important decline (26.4% in males and 22.3% in females). The truncated age standardized incidence rate of NPC in adults aged of 30 years old and more (N= 1209) decreased by -0.4% per year from 1994 to 2006 over time in north Tunisia dropping from 6.09 to 4.14 person-years. However, the rate was relatively stable during this period among youths aged 0-29 years (N= 233) in both sexes. NPC demonstrated a favorable evolution from 1994-2006 probably due to a improvement in socioeconomic conditions.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.399-408
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• 1998

Purpose : This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. Materials and Methods : The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. Results : The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2$\%$ over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6$\%$ with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. Conclusion : This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning. but prospective studies are required to define the true clinical benefit.

• Korean Journal of Head & Neck Oncology
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• v.8 no.2
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• pp.63-71
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• 1992

After analysis according to age, sex, site of origin, nodal involvement, perineural invasion. histopathology and treatment modality. authors had reached the following conclusion about the 28 cases of adenoid cystic carcinoma of the salivary gland, which were, histopathologically, diagnosed at Yonsei University Severance Hospital and Yongdong, Severance Hospital during the 8-year period from Apr. 1983 to Mar. 1991. Among the 28 cases, 13 were females and 15 were males, which implies that there isn't any sigificant distinction of gender. The age range was 24 years to 69 years with a mean age of 49 years, and the most common site of origin in order was 6 cases(21.4%) of maxillary sinus, 5 cases(17.8%) of submandibular gland, each 4 cases(14.4%) of parotid gland, palate, 3 cases(10.4%) of nasal cavity and each 2 cases(7.1%) of mouth floor, nasopharynx with each one case(3.6%) of buccal mucosa and retromolar trigone. With clinical staging by UICC, the 5-year survival of adenoid cystic carcinoma was 100% in stage I and II, 87.5% in stage III. In stage IV, all of the patient were died within 3 years. We have known that the prognosis was poorer in following cases; the cases with higher clinical stage, primary site other than the major salivary gland especially maxillary sinus and positive neural or nodal invasion.

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.197-201
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• 1990

The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system(RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.245-252
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• 2014

Human METCAM/MUC18, a cell adhesion molecule (CAM) in the immunoglobulin-like gene super family, plays a dual role in the progression of several epithelium cancers; however, its role in the nasopharyngeal carcinoma (NPC) remains unclear. To initiate the study we determined human METCAM/MUC18 expression in tissue samples of normal nasopharynx (NP), NPCs, and metastatic lesions, and in two established NPC cell lines. Immunoblotting analysis was used for the determination in lysates of frozen tissues, and immunohistochemistry (IHC) for expression in formalin-fixed, paraffin-embedded tissue sections of 7 normal nasopharynx specimens, 94 NPC tissue specimens, and 3 metastatic lesions. Human METCAM/MUC18 was expressed in 100% of the normal NP, not expressed in 73% of NPC specimens (or expressed at very low levels in only about 27% of NPC specimens), and expressed again in all of the metastatic lesions. The level of human METCAM/MUC18 expression in NPC tissues was about one fifth of that in the normal NP and metastatic lesions. The low level of human METCAM/MUC18 expression in NPC specimens was confirmed by a weak signal of RT-PCR amplification of the mRNA. Low expression levels of human METCAM/MUC18 in NPC tissues were also reflected in the seven established NPC cell lines. These findings provided the first evidence that diminished expression of human METCAM/MUC18 is an indicator for the emergence of NPC, but increased expression then occurs with metastatic progression, suggesting that huMETCAM/MUC18, perhaps similar to TGF-${\beta}$, may be a tumor suppressor, but a metastasis promoter for NPC.

• Radiation Oncology Journal
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• v.7 no.1
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• pp.29-36
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• 1989

One hundred and ten patients with carcinoma of the nasopharynx were treated by radiation therapy in Department of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1985. Among these, one hundred and five patients were treated with curative intent and 5 patients with palliative aim. Excluding 16 patients who did not receive a full course of radiation therapy, the remaining 89 patients were reviewed for this analysis. Minimum follow-up period of survivors was 36 months. Forty-three percent of the patients had T4 primary lesions and $72\%$ had stage IV disease. The histology was squamous cell carcinoma in $46\%$ of the patients. undifferentiated carcinoma in $49\%$, and lymphoepithelioma in $5\%$. Total radiation dose to the primary site averaged 6,500cCY for T1, T2 lesions and 7500cCY for T3, T4 lesions. Neck node were given boost treatment to a maximum 7,500cCY depending on the extent of disease. Early primary lesion (T1, T2) and neck nodes were successfully controlled in most cases when dose of greater than 6,500cCY was delievered. Forty two patients $(47\%)$ had recurred, 16 of whom $(38\%)$ed at the primary site and $24(57\%)$ developed distant metastases. Of these. 9 patients received re-irradiation with or without chemotherapy and local control was obtained in 2 patients$(22\%)$. Actuarial overall survival and disease-free survival rate was $42\%\;and\;38\%$ at 5 years. T-stage and histologic subtype were not correlated with survival. However, N-stage was related to survival significantly (p=0.043).

• Radiation Oncology Journal
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• v.8 no.1
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• pp.59-64
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• 1990

From 1980 to 1986,26 patients with metastatic carcinoma of the neck node from an unknown primary site were seen in the Department of Therapeutic Radiology of Seoul National University Hospital. Among these, three patients were excluded from further analysis due to incomplete treatment. So a retrospective analysis was undertaken on 23 patients who had complete treat-ment with radiation therapy alone or in combination with surgical treatment and chemotherpay. The overall three year actuarial survival rate was $32\%$. According to the staging system of the American Joint Committee on Cancer, the three year survival rates with N2 and N3 patients were $43\%\;and\;13\%$, respectively. In 16 patients with squamous cell carcinoma and seven with non-squamous cell carcinoma, the three year survival rates were $34\%\;and\;29\%$, respectively. Analysis according to site of nodal involvement was also done. Patients with cervical node and supraclavicular node involvement recorded $44\%\;and\;17\%$ of three year survival, rate, respectively. In this study, six patients eventually manifested the primary sites (three in the lung, one in the esophagus, one in the stomach, one in the nasopharynx). Presence of the primary site seemed to influence the prognosis ($17\%\;vs\;38\%$). In analyzing the prognostic factors, the nodal stage and site of nodal involvement were important prognostic factors, and the presence of a primary site seemed to influence the patients' survival, but histology did not.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.167-171
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• 2016

Patients undergone partial maxillectomy experience post-operative masticatory, phonetic, and swallowing difficulties. They also encounter social and psychological challenges due to changes in their facial appearances. Thus, functional and esthetic recovery through maxillofacial prosthesis becomes significant for these patients. The objective of an appropriate obturator is to restore palate and improve phonetic and swallowing ability by separating the oral cavity, nasal cavity, maxillary sinus, and nasopharynx. In this case report, an obturator was fabricated for a patient who had partial resection from the maxillary posterior region to the pharynx due to squamous cell carcinoma. The purpose of this case study is to describe the results because the patient was successfully improved both functionally and esthetically.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3411-3416
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• 2016

Background: Nasopharyngeal carcinoma (NPC), a malignancy arising from the epithelial lining of the nasopharynx, is distinct from others cancers in terms of its epidemiologic features. It is rare in most parts of the world except for a few regions with populations of Mongoloid origin. Objectives: To study the expression pattern of Epstein Barr virus (EBV) encoded oncoproteins EBNA1 and LMP1 in different histological types of NPC and to correlate expression patterns with sex, age and histological types. Materials and Methods: A total of 40 formalin-fixed, paraffin-embedded NPC biopsy samples and tissues from 20 healthy controls were collected to study the expression level of EBNA1 and LMP1 using immunohistochemistry. Results: EBNA1 and LMP1 expression was found in 92.5% and 90% respectively, of the cases and none of the control specimens. The expression patterns of EBNA1 and LMP1 were determined to be statistically significant (p<0.05) when correlated with sex, age and histological distributions. Also immunohistochemistry was found to be a sensitive technique in the detection of EBV. Conclusions: The study reveals that the potent oncoproteins EBNA1 and LMP1 were over expressed in our population cohort. Our findings are to some extent inconsistent with earlier reports as our population showed a higher expression of both EBNA1 and LMP1 compared to other studies.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.59-69
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• 1984

Guidelines for the optimal management of patients with cervical cancerous nodes from an unknown primary site, has not been yet settled. However. radical treatment has been advocated employing either a surgery, or radiotherapy, or a combination of the two in relation to the location, stage and histologic features of the nodes in the neck. Of 43 patients who presented with 'Cervical metastases from an unknown primary' since 1971, $31.2\%$ survived 3 years after adequate management. Combined modality with surgery and radiation showed more favorable treatment results: in local control rate, 3 year survival rates and the subsequent appearances of the contralateral side of neck node through the retrospective analysis. In 11 cases, the primary tumors became apparent later, carcinoma of the hypopharynx, being the most frequent site, rather than the nasopharynx.