ESMO Preceptorship Programme

Treatment of nasopharyngeal carcinoma in young

adults

Maja Baučić

University Hospital Centre “Zagreb”

Zagreb - Croatia

Head and Neck cancer – Zurich, Switzarland – 22-23 May 2018

ESMO PRECEPTORSHIP PROGRAMME

Disclosures

� No disclosures

ESMO PRECEPTORSHIP PROGRAMME

Patient G.J.

� Female, 27 years old

� Without past medical history and medication.

� Without past medical history and medication.

� No alcohol consumation.

� since November 2014. patient had occasional

headaches on the right side with deterioration of

hearing on right ear and consequently developed a

lump on the right side of her neck

ESMO PRECEPTORSHIP PROGRAMME

Diagnosis

� Initial clinical exam took place March 2015.

Diagnostic assessment included audiogram and

tympanometry with ENT specialist exam and biopsy

� Biopsy result – carcinoma nasopharyngeale,

EBER+

� Ca epipharyngis, Meta colli bil. T2N2MX

Initial CT scanApril 2015.

Infiltrative process follows in the

muscle area of the palatine and

promotes the nasopharynx. There

is an enlarged lymph node

14x12x26 mm in diameter.

In region II on the right side there

are two tumor enlarged lymph

nodes, of which one measures

15x21x26 mm and spreads to

region III, and the second

measures 15x30x41 mm. In

region III, behind the jugular vein,

a lymph node with diameter up to

10 mm has also been found.

In region II on the left positive

lymph node 10x14x22 mm in

diameter was detected.

ESMO PRECEPTORSHIP PROGRAMME

Treatment plan

� April 2015. – induction chemotherapy

cisplatin + 5-FU (1x)

� May 2015. – June 2015. – concurrent chemo/RT (IMRT +

mono cisplatin 3x)

� July 2015. – August 2015. – adjuvant chemotherapy

cisplatin + 5-FU (2x)

� Treatment side effects: radiation induced mucositis gr. I,

peripheral neuropathy gr. II

ESMO PRECEPTORSHIP PROGRAMME

SIB – IMRT TD 66Gy/30X

Post treatment

CT scan August 2015.

Regression of the infiltrative

process.

Regression of the enlarged lymph

nodes on the right.

Complete response of the tumor

enlarged lymph nodes on the left.

ESMO PRECEPTORSHIP PROGRAMME

Follow-up

� December 2015. – MRI scan: disease free

� June 2016. - MRI scan: disease free

� July 2017. - MRI scan: disease free

� February 2018. - MRI scan: disease free

� Next follow-up planned for August 2018.