Stage I nasopharyngeal cancer Treatment of stage I nasopharyngeal cancer usually involves treatment of the nasopharyngeal tumor with a single radiation therapy and prophylactic external radiation to the lymph nodes in the neck. Stage I nasopharyngeal carcinoma usually does not require adjuvant chemotherapy.
Stage II nasopharyngeal carcinoma Treatment of early stage II nasopharyngeal carcinoma (small tumors without lymphatic metastases) is usually treated with single radiation therapy to the nasopharyngeal tumor and prophylactic radiation to the neck.
For the rest of stage II, III and IV A/B nasopharyngeal carcinoma, a combination of radiotherapy and drug therapy may be considered. Chemotherapy can be administered before, at the same time as or after radiotherapy depending on the patient’s condition. Currently, radiotherapy combined with chemotherapy is more commonly used.
Stage IV-C (with distant metastases) patients have a poor prognosis. Systemic chemotherapy combined with palliative radiotherapy can be used for these patients. Patients with distant metastases should also be considered for treatment with new treatments offered by clinical trials.
Treatment of recurrent nasopharyngeal carcinoma The prognosis of recurrent nasopharyngeal carcinoma is very unsatisfactory. Treatment options for recurrent nasopharyngeal cancer include chemotherapy, surgical treatment, external radiation therapy combined with intracavitary radiation therapy, conformal intensity modulated external radiation therapy or gamma knife radiation therapy. The combined dose and scope of radiation therapy for recurrent nasopharyngeal cancer can be very limited because of the patient’s previous radiation therapy. Radiation oncologists will need to use specialized radiation techniques in order to administer secondary radiation therapy to areas that have previously been treated with radiation. Patients with recurrent nasopharyngeal cancer should also consider participating in clinical trials.