Nasopharyngeal cancer still needs to be reviewed after treatment

  At present, comprehensive treatment based on radiation therapy is the most effective treatment for nasopharyngeal carcinoma. However, a small number of patients still have local recurrence after treatment, which becomes one of the main reasons for failure after treatment for nasopharyngeal carcinoma. For local recurrence of nasopharyngeal cancer, if it can be detected early, there is a chance to choose some high-efficiency and low-toxicity methods for treatment, so that the tumor can be controlled more effectively and the survival quality can be better. The key to early detection of nasopharyngeal cancer recurrence lies in timely review after treatment.  Local recurrence is one of the main reasons for treatment failure of nasopharyngeal cancer. If the recurrence of nasopharyngeal cancer is detected early and the size of recurring tumor is small, microwave, radio frequency, laser and surgery can be used for treatment. These treatments can cure recurrent nasopharyngeal cancer and have the advantages of short treatment time, low cost, less toxic reactions and less sequelae. A group of patients with early recurrence of nasopharyngeal carcinoma have been treated with radiation therapy in our clinic and achieved better results. All of these patients with recurrent nasopharyngeal carcinoma who received radiotherapy are still alive, the longest being more than 10 years. The quality of survival of these patients is high, and most of them have been working.  Some patients with nasopharyngeal cancer do not follow the instructions of their primary care physicians or do not follow the prescribed time for review for other reasons, and wait until they have obvious symptoms or the recurring tumor is very large before they go to the hospital for examination, and as a result, they lose the opportunity for early treatment. These patients can only undergo radiotherapy, and some of them can only use palliative radiotherapy or chemotherapy because the tumor is too advanced.  Recently, we have admitted some patients with recurrence of nasopharyngeal cancer after treatment, and we deeply feel the importance of timely review after treatment. One of them was a recurrence in the nasopharynx, and the tumor destroyed the bone at the base of the skull and invaded the brain tissue. This patient received radiation therapy (intensity-modulated radiation therapy), but the recent outcome was not satisfactory. The other case was a recurrence in the lymph nodes of the neck, and the tumor invaded the skin and formed a cancerous ulcer. This patient could only receive palliative treatment, and the outcome was predictable. There were also 2 patients with nasopharyngeal recurrence in which the tumor invaded the large blood vessels in the parapharyngeal space. Both patients died due to failure of resuscitation for nasopharyngeal hemorrhage.  The majority of patients with nasopharyngeal cancer recurred within 5 years after treatment, with the number of recurrences within 3 years after treatment accounting for about 65% of all cases. Although there are not many patients with recurrence within 1 year after treatment, and due to the short interval between two radiotherapy treatments, the incidence of radiation sequelae is significantly increased and the severity of sequelae is significantly increased, which greatly reduces the survival quality of patients. Therefore, the review in the first year after treatment should be given sufficient attention.  When should I return to the hospital for review after radiotherapy for nasopharyngeal cancer? According to the requirements of nasopharyngeal cancer diagnosis and treatment standard, nasopharyngeal cancer should be reviewed every three months in the first three years after treatment; every six months in the fourth and fifth years after treatment; and once a year after five years of treatment. In case of abnormalities, one should immediately return to the hospital for examination.