Uncommon in the US, but WHO III (undifferentiated) common in Southern China and Hong Kong (e.g., third most common cancer among men in Hong Kong). Strongly associated with EBV (70% of patients have + titers). Two peak ages: 15–25 years and 50–60 years. More common among men (2:1). Alcohol and tobacco are associated with WHO type I (keratinizing SCC). Borders of the nasopharynx: anterior = posterior end of nasal septum and choanae; posterior = clivus and C1-2 vertebral bodies; superior = sphenoid bone/sinus; inferior = roof of soft palate. The parapharyngeal and masticator spaces are lateral to the nasopharynx. Villaret/jugular foramen syndrome = extension to the parapharyngeal space causing symptoms related to involvement of CN IX–XII and cervical sympathetics. Involvement of the masticator space causes trismus. The Eustachian tubes enter the lateral nasopharynx, and the posterior aspect of the orifice creates a protuberance (torus tubarius). Rosenmueller’s fossa is posterior to the torus tubarius and is the number 1 location for nasopharyngeal cancer.
KeywordsEustachian Tube Masticator Space Supraclavicular Fossa Temporal Lobe Necrosis Torus Tubarius
We thank Dr. M. Kara Bucci for her contribution to this chapter in the first edition.
- Chan AT, Teo PM, Leung TW, et al. A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Phys 2005a;33:569-77.Google Scholar
- Children’s Oncology Group. Protocols: ARA 0331. Available at: https://members.childrensoncologygroup.org/prot/default.asp (password required). Accessed on February 10, 2009.
- Chua DT, Sham JS, Choy D, et al. Preliminary report of the Asian-Oceanian Clinical Oncology Association randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. Cancer 1998;83:2270-2283.PubMedCrossRefGoogle Scholar
- ClinicalTrials.gov. Induction chemotherapy and chemoradiotherapy in nasopharyngeal cancers (GORTEC-NPC2006). Available at: http://clinicaltrials.gov/ct2/show/NCT00828386. Accessed on March 10, 2009.
- Garden AS. The Nasopharynx. In: Cox JD, Ang KK, editors. Radiation oncology: rationale, technique, results. 8th ed. St. Louis: Mosby; 2003. pp. 178-195.Google Scholar
- Greene FL, American Joint Committee on Cancer, American Cancer Society. AJCC cancer staging manual. 6th ed. New York: Springer; 2002.Google Scholar
- International Nasopharynx Cancer Study Group. Preliminary results of a randomized trial comparing neoadjuvant chemotherapy (cisplatin, epirubicin, bleomycin) plus radiotherapy vs. radiotherapy alone in stage IV (≥ N2, M0) undifferentiated nasopharyngeal carcinoma: a positive effect on progression-free survival. Int J Radiat Oncol Phys 1996;35:463-469.Google Scholar
- Lee N, Fu K. Cancer of the Nasopharynx. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 579-600.Google Scholar
- Lee AW, Perez CA, Law SC, et al. Nasopharynx. In: Halperin EC, Perez CA, Brady LW, editors. Principles and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 820-857.Google Scholar
- National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Head and Neck Cancers. Available at: http://www.nccn.org/professionals/physician_gls/PDF/head-and-neck.pdf. Accessed on February 10, 2009.
- National Cancer Institute. Nasopharyngeal Cancer (PDQ): Treatment. Available at: http://cancer.gov/cancertopics/pdq/treatment/nasopharyngeal/healthprofessional/. Accessed on February 10, 2009.
- Pow EH, Kwong DL, McMillan AS, et al. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Onc Biol Phys 2006;66:981-991.Google Scholar
- Radiation Therapy Oncology Group. RTOG Head & Neck Cancer Protocols. Available at: http://www.rtog.org/members/active.html#headneck. Accessed on February 10, 2009.
- Wee J, Tan EH, Tai BC, et al. Randomized trial of radiotherapy versus concurrent chemo-radiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union Against Cancer Stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol 2005;23:6730-6738.PubMedCrossRefGoogle Scholar