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Comparison of 3-Dimensional Radiotherapy with IMRT for nasopharyngeal cancer - Dissertation Example

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Literature review Primary Concerns and Challenges in Treating Nasopharyngeal Cancers Head and neck cancers remain a daunting challenge in oncology mainly due to the presence of many vital structures in this area, as well as its location at the base of the skull…
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Comparison of 3-Dimensional Radiotherapy with IMRT for nasopharyngeal cancer
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Download file to see previous pages The treatment modality therefore, revolves around successful and complete removal of the tumour mass without damage to the vital organs around the tumour (Tham and Lu, 2010). Most of the critical analysis presented in this research is based on findings that have been carried out on patients of Eastern Asian origin. This is because nasopharyngeal carcinomas are prevalent in this population group. On the same note, some of the most significant research results and tabulations have been obtained from studies carried out in these geographical areas. One of the most significant facts about NPC is that these are diagnosed in later stages of cancer (Afqir, Ismaili and Errihani, 2009, pp 3). The close proximity of different regions leads to many problems after treatment is carried out. Adverse effects to the pituatory, thyroid and hypothalamic glands are commonly seen post treatment (Stevens et al, 1998). Soft tissue fibrosis leading to trismus and necrosis of the eye structures is also commonly seen (Stevens et al, 1998). Surgical treatment options are somewhat reserved due to the complex location of the tumour. Studies researching the efficacy of surgical treatment have shown higher tissue destruction, and increased chances in recurrence and metastasis, which are reflected in high mortality rates, with five year survival rates falling in the range of 33-57% only (Leu and Lee, 2009, pp 103). A similar study assessed the effects of salvage surgery on patients with recurrent nasopharyngeal carcinoma after radiation therapy. The study selected 38 patients with recurrence in NPC who underwent surgery (Chang et al, 2004, pp 499). The results showed a 3 year survival rate and local control rate of 69 and 72.8% respectively. Local control rates at the intracranial and skull base levels were 83.3%, and the overall morbidity rates were below 14% (Chang et al, 2004, pp 500). Morbidity rates with radiotherapy treatment alone fall between 40 To 50%, whereas combined radio and chemotherapy provide survival rates of 55 to 80% respectively (Paulino and Louis, 2010). However, this study has very limited number of participants, making it difficult to state that the results are significant. However, when viewed in comparison to many other studies on the efficacy of combined radiotherapy, the results bear some significance. Another important consideration is that surgery can still become an option in cancers which are of larger size, in order to help reduce the severity and duration of the chemoradiation therapy. Very large cancers can be removed with the help of fine surgical instruments, after which pockets of tumour can be removed through radiation and chemotherapy. Surgical treatments however, have been largely replaced by the newer and more sophisticated technology of irradiation. However, chemotherapy is another major contender for treatments of NPC. Many drugs have been introduced, but so far, trials and researches have gathered evidence for cisplatin and 5-florucil respectively. Trials of use of cisplatin combined with radiotherapy for NPC have shown an overall survival rate of 76% at two to three years, which is comparatively better than therapy from any one of the methods alone. Another trial on 130 patients showed a 46% rate of survival with combined chemotherapy compared to 25% of it when treatment was done with radiation alone at five years (Siewert, Salama and Vokes, 2006, pp 168 and 169). Other drugs that are being used or considered for combined ...Download file to see next pagesRead More
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