Nasopharyngeal carcinoma natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]Faizan Sheraz, M.D. [3]

If left untreated nasopharyngeal carcinoma produces few symptoms early in the course of the disease. Non-keratinizing nasopharyngeal carcinoma is associated with a 5 year survival rate of 65%. The common complications of nasopharyngeal carcinoma’s treatment include Radiation necrosis of the temporal lobes, Cranial nerve palsies, encephalomyelopathy, Atrophy and fibrosis of the muscles of mastication, atrophy of salivary glands, hearing loss, and osteoradionecrosis.

• If left untreated nasopharyngeal carcinoma produces few symptoms early in its course.
• Once the tumor has expanded from its site of origin in the lateral wall of the nasopharynx, it may obstruct the nasal passages and cause nasal discharge or epistaxis.^[1]

Complications of radiotherapy include:^{[2][3][4][5][6][7]}

• Neurologic complications:
  • Radiation necrosis of the temporal lobes
  • Cranial nerve palsies
  • Encephalomyelopathy
• Non- neurologic complications:
  • Atrophy and fibrosis of the muscles of mastication
  • Atrophy of salivary glands
  • Hearing loss
  • Osteoradionecrosis

Complications of chemotherapy include:^[8]

• Suppression of bone marrow

• Hearing loss

• Renal impairment

Prognosis of nasopharyngeal carcinoma is influenced by tumor type:^[9][10]

• Type I: Keratinizing squamous cell carcinoma – 42% 5 year survival
• Type II: Non-keratinizing squamous cell carcinoma – 65% 5 year survival
• Type III: Undifferentiated carcinoma – 14% 5 year survival

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