nasopharyngeal carcinoma treatment guidelines

January 25, 2021

What patients and caregivers need to know about cancer, coronavirus, and COVID-19. In 2018, the global age-standardised incidence rates varied from 2.1 to 0.4 per 100 000 in Asia and Europe, respectively.1 The highest age-standardised incidence rates per 100 000 were in East and South East Asia (e.g. Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Ask your cancer care team questions. It is invasive with risk of hemorrhage or infection. Accessed at www.cancer.gov/types/head-and-neck/patient/adult/nasopharyngeal-treatment-pdq on April 24, 2018. Experts agree that the best way to treat NPC in the more advanced stages is in a clinical trial. New drug treatments and new surgical procedures being tested in clinical trials may help some people with recurrent NPC, as well as improve knowledge that can help others with NPC in the future. 1,2 NPC cells are highly sensitive to irradiation, which has resulted in radiotherapy (RT) becoming the mainstay treatment modality for nonmetastatic NPC. METHODS The Chinese Society of Clinical Oncology (CSCO) and ASCO convened an expert panel of radiation oncology, medical oncology, surgery, and … Post the guideline on the Alberta Health Services Web site. For all nasopharyngeal carcinoma (NPC) patients, intensity modulated radiotherapy (IMRT) with daily image guidance should be offered. It’s important to weigh the benefits of each treatment option against the possible risks and side effects. The Alberta Provincial Head and Neck Tumour Team adopted the recommendations from the following source, with modifications to fit the Alberta context: National Comprehensive Cancer Network. Alternative treatments are used instead of a doctor’s medical treatment. The targeted drug cetuximab may be given along with chemo, but this is usually done as part of a clinical trial. This guideline was reviewed and endorsed by the Alberta Provincial Head and Neck Tumour Team, which is comprised of over 150 health care professionals from various disciplines. Available Every Minute of Every Day. Whether you or someone you love has cancer, knowing what to expect can help you cope. National Comprehensive Cancer Network. This is preventive (prophylactic) radiation. Whether you are thinking about treatment, getting treatment, or not being treated at all,  you can still get supportive care to help with pain or other symptoms. HN-003). Although there are too few cancer cells in the lymph nodes to cause them to be enlarged, these cells could continue to grow and spread if not destroyed by radiation therapy. The choice of chemotherapy should be individualized based on patient characteristics (performance status and goals of therapy). Palliative RT can be considered in select cases. Review of Published Meta-Analyses Systematic Review with Evidence Tables. Some NPCs diagnosed before the current staging system was in place may have been given the stage IVC. NPC is commonly treated with radiotherapy (RT) and chemotherapy. You can help reduce your risk of cancer by making healthy choices like eating right, staying active and not smoking. Advanced-stage (T1, N1–3; T2–4, Any N, M0): Concurrent chemoradiotherapy (chemoRT) with cisplatin is recommended. Don't hesitate to ask him or her questions about your treatment options. To recommend a cranial border for level IIb in delineating clinical target volumes (CTV) for nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy and to help reach a consensus on contouring level IIb in CTV. Clinicians applying these guidelines should, in consultation with the patient, use independent medical judgment in the context of individual clinical circumstances to direct care. You may feel that you need to make a decision quickly, but it’s important to give yourself time to absorb the information you have learned. Nasopharyngeal carcinoma (NPC), or nasopharynx cancer, is the most common cancer originating in the nasopharynx, most commonly in the postero-lateral nasopharynx or pharyngeal recess (fossa of Rosenmüller), accounting for 50% of cases.NPC occurs in children and adults. Your cancer care team will recommend treatment options depending on the stage – the extent of the cancer in the nasopharynx and if and how far the cancer has spread. The American Cancer Society couldn’t do what we do without the support of our partners. Note: Different principles may apply to pediatric patients. What does it take to outsmart cancer? Participation of members of the Alberta Provincial Head and Neck Tumour Team in the development of this guideline has been voluntary and the authors have not been remunerated for their contributions. Get detailed information about the treatment of newly diagnosed and recurrent nasopharyngeal cancer in this summary for clinicians. Guidelines for the treatment of nasopharyngeal carcinoma (NPC), issued by the American College of Radiology (ACR) in 2015, include the following recommendations [ 71] : Nasopharyngectomy, stereotactic radiation therapy (SRT), intensity-modulated radiation therapy (IMRT), or … However the developers of this guideline are satisfied it was developed in an unbiased manner. Register Diagnosis Evaluation Management Treatment, Nutrition Oncology Otolaryngology Radiation Oncology Radiology Speech-Language Pathology, Advanced Practice Nurses Allied Health Personnel Dentists Dietitians Nurses Physician Assistants Physicians Speech-Language Pathologists, To outline treatment recommendations for patients with nasopharyngeal cancer (NPC), Adults over the age of 18 years with nasopharyngeal cancer (NPC). Moreover, the views and opinions of developers or authors of guidelines represented on this site do not necessarily state or reflect those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or hosting of guidelines in NGC may not be used for advertising or commercial endorsement purposes. Treatment for nasopharyngeal cancer may cause side effects. Intensity-modulated radiation therapy (IMRT) should be used to reduce critical structure doses to acceptable levels. Nasopharyngeal carcinoma (NPC) is a disease with unique epidemiological features. Abstract: Nasopharyngeal carcinoma (NPC) is a unique disease endemic in Asia. Patients with stage II-IVB nasopharyngeal cancers are treated with concurrent chemotherapy and radiation +/- adjuvant chemotherapy or with induction chemotherapy followed by … Members of your MDT will discuss with you what they think the best treatment option is in your case. Specific research questions to be addressed by the guideline document were formulated by the guideline lead(s) and Knowledge Management (KM) Specialist using the PICO question format (patient or population, intervention, comparisons, outcomes). Another option in some cases is to give chemoradiation as the first treatment. Nasopharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the nasopharynx. What is the recommended follow-up after treatment for NPC? What diagnostic and baseline investigations are recommended for patients with suspected or confirmed nasopharyngeal cancer (NPC)? But if doctors believe that more radiation would cause serious side effects or if the cancer didn't respond to radiation the first time, surgery (neck dissection) may be used instead. This is the current release of the guideline. As detailed in the Guideline Utilization Resource Unit Handbook (see the "Availability of Companion Documents" field), the working group members may decide to adopt the recommendations of another institution without any revisions, adapt the recommendations of another institution or institutions to better reflect local practices, or develop their own set of recommendations by adapting some, but not all, recommendations from different guidelines. Incidence. For example, if the cancer has spread to the spine, radiation may be given to the area to relieve pain and reduce the chances of further problems. Some might even be harmful. Alberta Provincial Head and Neck Tumour Team. Depending on the size of the document, and the number of people it is sent to for review, a deadline of one to two weeks will usually be given to submit any feedback. Objective: Explore the usefulness of pre-treatment CTperfusion (CTP) and clarify the parameters in predicting the treatment response. Learn more about the risk factors, symptoms, tests to diagnose, and treatment of childhood nasopharyngeal cancer in this expert-reviewed summary. Become a volunteer, make a tax-deductible donation, or participate in a fundraising event to help us save lives. Knowing all of your options and finding the resources you need will help you make informed decisions about your care. To get started, log in or create your free account Create Account, © Guideline Central 2021 | All Rights Reserved – Privacy, Terms, and Rights, CPT© copyright 2019 American Medical Association. Members of the Alberta Provincial Head and Neck Tumour Team include medical oncologists, radiation oncologists, head and neck surgeons, head and neck reconstructive surgeons, oral and maxillofacial surgeons, dentists, neuroradiologists, nurses, speech and language pathologists, pathologists, pharmacists, and other allied health professionals. People with cancer need support and information, no matter what stage of illness they may be in. CancerControl Alberta recognizes that although industry support of research, education and other areas is necessary in order to advance patient care, such support may lead to potential conflicts of interest. Readers with questions regarding guideline content are directed to contact the guideline developer. The nasopharynx is the upper part of the pharynx () behind the nose.The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea and esophagus (the tube that goes from the throat to the stomach). Guidelines represented on the NGC Web site are submitted by guideline developers, and are screened solely to determine that they meet the NGC Inclusion Criteria which may be found at http://www.guideline.gov/about/inclusion-criteria.aspx. For standard treatment, all cases should be presented and discussed at a multidisciplinary Tumour Board to decide the best treatment option for each patient. Development of a nomogram model for treatment of nonmetastatic nasopharyngeal carcinoma. If there are still signs of cancer after the initial chemo, another chemo regimen using different drugs may be tried. These NPCS have spread to distant parts of the body and can be hard to treat. The working group members formulated the guideline recommendations based on the evidence synthesized by the Knowledge Management (KM) Specialist during the planning process, blended with expert clinical interpretation of the evidence. Where there is clinical evidence of residual disease in the neck, neck dissection is recommended, if feasible. Version 1.2019. Childhood nasopharyngeal cancer treatment options include chemotherapy, external and internal radiation therapy, surgery, and immunotherapy (interferon). Nasopharyngeal Carcinoma Clinical Practice Guidelines – Nasopharyngeal Carcinoma 21 Dec 2020. The cancer has not yet spread to lymph nodes in these stages, but the nearby lymph nodes in the neck are usually treated with radiation therapy as well. With advancements in technology, high target conformality is possible. The information was verified by the guideline developer on September 25, 2014. Depending on the stage of the cancer, your overall health, and other factors, your treatment options may include: Depending on the stage of the cancer, you may get more than 1 of these treatments. All guidelines summarized by NGC and hosted on our site are produced under the auspices of medical specialty societies, relevant professional associations, public or private organizations, other government agencies, health care organizations or plans, and similar entities. Nasopharyngeal carcinoma arises in the lining of the nasal cavity and pharynx, and it accounts for about one-third of all cancers of the upper airways in children. All so you can live longer — and better. Other treatment options in these stages include induction chemo followed by chemoradiation or just chemoradiation, or possibly immunotherapy (alone or with chemo). National Cancer Institute. Three types of standard treatment are used: Radiation therapy Chemotherapy ; Surgery ; New types of treatment are being tested in clinical trials. Please see the distant metastatic disease treatment algorithm in the original guideline document. 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