Nasopharyngeal cancer: an update on diagnosis and treatment

Nasopharyngeal carcinoma (NPC) has distinct epidemiological and histological features among head and neck cancers. Clinical signs in patients with NPC change according to the tumor size and the status of lymph node metastases. Tumor can expand anteriorly to nasal cavity, pterygoid fossa or maxillary sinus, laterally to parapharyngeal space and infratemporal fossa, or posterosuperiorly to cranial base, clivus and intracranial structures. Radiotherapy is the primary treatment in NPC. In tertiary centers, intensity modulated radiotherapy (IMRT) is the preferred radiotherapy module. Concurrent chemoradiotherapy is the standard treatment of locally advanced NPC. Standard regimen includes radiation to 70 Gy to the gross tumor in daily fractions of 2 Gy and additional chemotherapy which includes 100 mg/m2 of cisplatin every 3 weeks or 30-40 mg/m2 once a week. In this article, updated staging in American Joint Committe on Cancer (AJCC) 8th edition guidelines, diagnostic methods and treatment modalities in NPC are reviewed and presented in the light of current literature