Leaderboard Ad

Myers Lecturer Discusses Nasopharyngeal Cancer

Professor Sheng-Po Hao, MD, FICS, delivers the “Eugene N. Myers, MD International Lecture on Head and Neck Cancer” Tuesday morning.

Professor Sheng-Po Hao, MD, FICS, delivers the “Eugene N. Myers, MD International Lecture on Head and Neck Cancer” Tuesday morning.

Professor Sheng-Po Hao, MD, FICS, delivered the “Eugene N. Myers, MD International Lecture on Head and Neck Cancer” Tuesday morning, fulfilling one of his personal dreams.

Dr. Hao, professor and chairman of the Department of Otolaryngology of Shin Kong Wu Ho-Su Memorial Hospital and Fu Jen Catholic University in Taiwan, claims Dr. Myers as his mentor. He was Dr. Myers’ International Fellow at the University of Pittsburgh from 1992 to 1993.

“It has always been an honor to have Dr. Myers’ encouragement throughout my career,” he said. “This is truly an honor.”

Dr. Hao addressed the treatment of nasopharyngeal cancer (NPC) during his talk, “Management of NPC—State of the Art.”

“NPC is a unique malignancy with an endemic distribution among certain well-defined ethnic geographic groups,” he said. “It is one of the most common head and neck cancers among the Chinese population, but is a rare cancer among Caucasians in Europe and North America.”

Currently available therapeutic modalities for NPC are radiation therapy (RT), chemotherapy, or a combination of both, he said. NPC is highly radiosensitive and patients presenting with early disease have a high cure rate after RT. The treatment of NPC with current RT techniques can achieve a local control rate of more than 80 percent. Concurrent cisplatin-based chemo-radiotherapy with or without neo-adjuvant chemotherapy has demonstrated significant survival improvement and is currently the standard treatment strategy for patients with locoregionally advanced disease.

“Though NPC are radiosensitive tumors, they do recur after RT,” he said. “Local failure, either persistence or recurrence, in the nasopharynx, occurs in 10 percent to 30 percent of patients with NPC after initial RT.”

Once NPC recurs in the nasopharynx, salvage nasopharyngectomy should be the treatment of choice as there is no reason to believe that the NPC cells, which are resistant to a first course of RT, would respond to a second course of radiation, not to mention the risk of skull base osteoradionecrosis—a potentially fatal complication of high dose RT, he said.

“Salvage nasopharyngectomy has been the mainstay of treatment after RT failure,” Dr. Hao said. “Surgical access to the nasopharynx has been a challenge to head and neck surgeons for years. Various surgical approaches to the nasopharynx have been developed along the years, such as transpalatal, transmaxillary, midline mandibulotomy, transpterygoid, facial translocation, and infratemporal fossa approaches. However, these open approaches usually involve facial incision and scars, and might potentially generate some psychiatric impact on the patients. In recent years, there has been a paradigm shift in nasopharyngectomy—from open to endoscopic.” 

Top