Diagnostic, Therapeutic and Evolutionary Characteristics of Nasopharyngeal Cancer in Morocco

Background: Nasopharyngeal carcinoma (NPC) is a radiosensitive and radio curable cancer, the radiation therapy (RT) is the mainstay of treatment with significant improvement in survival of patients. The aim of this study was to report the experience of Military Hospital Mohamed V in the management of NPC and their results. Materials and methods: 83 no metastatic NPC patients managed at the radiotherapy department of Military Hospital Mohammed V of Rabat in Morocco, between January 2005 and December 2009, were included for investigation of their demographic, histological, therapeutic and follow-up characteristics. Statistical analysis of the data was carried out by the SPSS for Windows. Results: The mean age was 44.5 ± 12.5 years with sex ratio 4:1. At diagnosis, rhinologic symptoms represented the most common clinical presentation, reported by 56 (67, 5%) patients. Almost ninety percent (n=74) of patients presented UCNT histology. Most of the patients (85.5%) presented a locally advanced disease; stage III and IV. Therefore, forty patients (48.2%) were treated by concurrent chemoradiotherapy and 35 patients (42.2%) received induction chemotherapy. With a mean follow up of 70 ± 32 months, twenty nine patients (34.9%) died, 6 (7.2%) presented local or locoregional relapse. While 11 (13.2%) patients presented distant recurrences. The five years overall survival (OS) was 68% ranging from 91% for both stage I and II, 79.3% for stage III to 40% for stage IV. The five years disease free survival (DFS) was 81.1%, whereas distant failure free survival (DFFS) was 84.1%. In multivariate analysis, the disease stage according to the seventh edition of the AJCC system was an independent prognostic factor. Conclusion: Our outcomes in NPC are similar to the literature. Patients’ survival is directly impacted by the disease staging which is the most important prognostic factor. We hope to improve these results with the recent acquisition of volumetric-modulated arc therapy machines. is a few data about incidence coming from several cities such as Casabalanca (3, 74 per 100,000 men/year versus 0, 88 per 100,000 women/year in 2004) [5] or rabat (3, 3 per 100,000 men per year versus 1, 8 per 100,000 women per year in 2005) [6]. The male-to-female incidence ratio is 2:1 to 3:1. [7]. A bimodal age distribution is observed in low-risk populations (such as Europe and North America). The first peak incidence arises between 15 to 25 years of age, with the second peak at 50 to 59 years of age [8-10]. In high-risk populations (including Southeast Asia, North Africa, Eskimos) [11,12], the peak incidence occurs in the fourth and fifth decades of life [8]. Since it is a clinically occult site, patients may remain asymptomatic for a prolonged period. The majority of patients has a locally and/ or regionally advanced disease because of this asymptomatic period or, in some cases, due to a missed diagnosis [13,14]. Diagnosis of Citation: Marnouche E, Elmarjany M, Razine R, Maghous A, Lalya I, et al. (2017) Diagnostic, Therapeutic and Evolutionary Characteristics of Nasopharyngeal Cancer in Morocco. J Cancer Sci Ther 9: 439-444. doi: 10.4172/1948-5956.1000456 J Cancer Sci Ther, an open access journal ISSN: 1948-5956 Volume 9(5) 439-444 (2017) 440 nasopharyngeal carcinoma is made by biopsy of the primary tumor or Fine-needle aspiration of a suspicious neck mass. The staging workup is performed, as disease staging according to the American Joint Committee on Cancer staging system AJCC is considered as the most important prognostic factor. The development of radiation therapy (RT) revolutionized the management of nasopharyngeal carcinoma with the advent of megavoltage machines; the review by Moss [15] in 1965 showing 25% of patients alive at 5 years marked the first major breakthrough and established the role of RT as the primary modality of choice [16]. The adjunction of concurrent chemotherapy has more improved survival [17]. Recent development in RT techniques with Intensity-modulated radiotherapy (IMRT) further improved tumor coverage and organs at risk sparing. The aim of this study was to report the experience of Military Hospital Mohamed V in the management of NPC.