L’apport de la radio-chimiothérapie concomittante dans la prise en charge du carcinome indifférencié du nasopharynx de l’adulte

This study aimed to investigate the epidemiological, clinical, therapeutic and evolutionary features of undifferentiated carcinoma of the nasopharynx in adults. We conducted a retrospective cohort study of 163 patients aged 17 years old and over, treated for non metastatic undifferentiated carcinoma of the nasopharynx. The average age of our patients was 46,5 years, with a sex-ratio of 1.7; 35.57% of patients had locally advanced tumors (T3-T4) and 52.27% had advanced regional lymph nodes involvement (N2-N3). Neoadjuvante chemotherapy was performed in 77% of patients and 93.8% of patients underwent concomitant radiochemotherapy. After a mean follow-up interval of 40.8 months overall survival was 92.9% and relapse-free survival (RFS) was 78.9%. Relapse-free survival was caculated according to different prognostic factors, revealing a statistically significant difference based on lymph nodes involvement; three-year RFS rates were 88%, 82.6%, 80.8% and 61.5% in patients with tumor classified as N0, N1, N2 and N3, respectively (p = 0.02). Nasopharyngeal cancer is a complex disease, but progress has been made thanks to advances in radiotherapy and molecular biology. Concomitant radiochemotherapy is the therapeutic standard for patients with clinical stage greater than or equal to T2, or greater than or equal to N1. The innovative techniques in radiation therapy appear promising and they could reduce late toxicity while ensuring an excellent local control rate.