300P - Endoscopic nasopharyngectomy for localized stage I nasopharyngeal carcinoma

Background

The National Comprehensive Cancer Network guidelines recommend intensity-modulated radiotherapy (IMRT) as primary curative treatment for newly diagnosed nasopharyngeal carcinoma (NPC), but the radiation-related complications and relatively high medical costs cannot be ignored. We examined whether endoscopic nasopharyngectomy (ENPG) could be an effective alternative treatment for localized stage I NPC.

Methods

Ten newly diagnosed localized stage I NPC patients received ENPG alone from June 2007 to September 2017 in Sun Yat-sen University Cancer Center. The survival outcomes, quality of life (QOL), and medical costs were collected. Simultaneously, data for 329 stage I NPC patients treated with IMRT were collected as a reference.

Results

After a median follow-up of 59.0 months (95%CI 53.4-64.6), no death, locoregional recurrence, or distant metastasis was observed in the 10 ENPG-treated patients. The 5-year overall survival, local relapse-free survival, regional relapse-free survival and distant metastasis-free survival among the ENPG-treated patients was similar to that among the IMRT-treated patients (100% vs. 99.1%, 100% vs. 97.7%, 100% vs. 99.0%, 100% vs. 97.4%, respectively, P > 0.05). In addition, compared with IMRT, ENPG was associated with decreased total medical costs ($4090.42±1502.65 vs. 12620.88±4242.65, P < 0.001) and improved QOL scores including dry mouth (3.3 ± 10.5 vs. 34.4 ± 25.8, P < 0.001) and sticky saliva (3.3 ± 10.5 vs. 32.6 ± 23.3, P < 0.001).

Conclusions

ENPG alone was associated with promising long-term survival outcomes, low medical costs, and excellent QOL and might therefore be an alternative strategy for treating newly diagnosed localized stage I NPC patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Mingyuan Chen.

Funding

National Natural Science Foundation of China.

Disclosure

All authors have declared no conflicts of interest.