Current status of cancer care for young patients with nasopharyngeal carcinoma in Jakarta, Indonesia

M. Adham, S.D. Stoker, M.A. Wildeman, L. Rachmadi, S. Gondhowiardjo, D. Atmakusumah, D. Gatot, R. Fles, A.E. Greijer, B. Hermani, J.M. Middeldorp, I.B. Tan

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Abstract

Background
Nasopharyngeal carcinoma (NPC) is endemic in Indonesia and 20% of the patients are diagnosed before the age of 31. This study evaluates presentation and treatment outcome of young patients in Jakarta, in a tertiary referral centre.

Methods
Forty-nine patients under the age of 31, diagnosed with NPC between July 2004 and January 2007, were evaluated. Baseline data included histological type, stage of disease and presenting symptoms. We intended to follow all patients after diagnosis to reveal treatment outcome and overall survival (OS).

Results
All but two patients had advanced stage disease (94%), 7 (14%) had distant metastasis. The median interval between start of complaints and diagnosis was 9 months. Forty-two patients were planned for curative intent treatment. Eleven patients (26%) never started treatment, 2 patients did not complete treatment and 3 patients did not return after finishing treatment. Four patients died before radiation could start. Three patients died within 4 months after treatment. Nine patients (21%) had a complete response. Due to the high number of patients who were lost to follow-up (LFU), OS was analyzed as follows: a best-case (patients censored at last contact) and a worst-case scenario (assuming that patients who did not finish treatment or had disease at last contact would have died). The 2-year OS for patients without distant metastases was 39-71%.

Conclusion
Treatment outcome for young patients with NPC in this institute was poor. Improvement can be achieved when NPC is diagnosed at an earlier stage and when there is better treatment compliance.
Original languageEnglish
Article numbere102353
Pages (from-to)e102353
Number of pages9
JournalPLOS ONE
Volume9
Issue number7
DOIs
Publication statusPublished - 2014

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