Nasopharyngeal Carcinoma

Abstract

Intensity-modulated radiation therapy is the primary treatment modality for definitive treatment of nasopharyngeal cancer. Both physical examination and imaging data in particular MRI with gadolinium for detailed examination of the skull base are required for accurate delineation of the primary tumor. An endoscopic examination should be performed focusing on the anterior nasal space, nasopharynx, and oropharynx to describe the tumor extension and infiltration. EBER status should be obtained from tissue biopsies to assist in the discussion of prognosis. When available, plasma EBV DNA should be obtained and, given its non-uniform detection across different laboratories, plasma EBV DNA should be done in a CLIA or equivalent certified laboratory. Please refer to NRG HN001 clinical trial. This chapter discusses general principles and suggested target volumes for the GTV and CTV. It also provides several delineation examples for nasopharyngeal carcinoma. The reader can refer to NRG HN001 for further discussion on target delineation. The reader can also refer to the international consensus guideline for NPC target delineation.