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The majority (75%to9090%) of newly diagnosed NPC patients have loco-regionally advanced disease, commonly with cervical nodal metastases [8], indicating that most NPC patients are not promptly diagnosed.
At the time of clinical diagnosis only 30 40 % patients have loco-regionally confined disease that is amenable to potentially curative therapy and the majority of patients relapse systemically after such treatment [ 1].
Within the surgery with adjuvant radiotherapy (n=110), definitive radiotherapy-alone (n=24) and definitive radiotherapy with chemotherapy (n=47) groups, patients with HPV-positive cancers were one-third or less as likely to have loco-regional recurrence, an event or to die of any cause as those with HPV-negative cancers after adjusting for age, gender, tumour grade, AJCC stage and primary site.
The mean age was 47.2 (SD = 13.5) years, most were married (68%), and had completed primary or secondary education (66%), and had loco-regional disease (45%).
Of these, 50 had loco-regional disease and received curative therapy (chemotherapy and surgery), while 55 had advanced disease and poor performance and received palliative treatment.
Many (44.2%) patients with CRNP had loco-regional progression of cancer and approximately half (49.0%) experienced metastasis of the disease in one or more site (Table 5).
Among the patients recruited, 60% were node-positive, 70% had no recurrence, 9% had distant metastasis and 24% had loco-regional recurrence at the time of completing the analysis.
We recruited 20 patients who were diagnosed as having loco-regionally advanced, non-metastatic stage III or IVa NPC and treated with concurrent platinum-based chemoradiotherapy (CRT) using IMRT.
While the Oncept vaccine was proven to be safe and preliminary data indicated that it significantly enhanced survival when used in the setting of loco-regional control, [ 11] a recent retrospective clinical study failed to replicate these findings dogs with oral melanoma that had loco-regional tumor control [ 10- 14].
The DAHANCA report 2007[50] has stated that the administration of Darbepoetin Alfa results in greater mortality than with placebo while patients who receive Epoetin Beta have poor loco-regional progression of tumours (Henke et al., (2003) [51].
* Patients who have a loco-regional recurrence or contra-lateral breast cancer were excluded.
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