Modalities of surveillance in treated nasopharyngeal cancer

Abstract

OBJECTIVE: We sought to assess the efficacy of different modalities in the detection of disease during the early posttreatment period of nasopharyngeal carcinoma (NPC). STUDY DESIGN AND SETTING: We prospectively evaluated 57 patients with NPC who were treated with radiation. A postnasal space (PNS) biopsy, an endoscopic examination, and computed tomography (CT) scans were performed 4 months after treatment. RESULTS: Four patients had evidence of disease in the PNS biopsy specimen. The sensitivity, specificity, and positive and negative predictive values of the endoscopic examination were 75%, 94.3%, 50%, and 98%, respectively, while those of the CT scan were 50%, 49.1%, 6.9%, and 92.9%, respectively. CONCLUSION: In the early postradiation period for patients with NPC, an endoscopic examination is a suitable surveillance modality, but routine CT scanning has no added clinical benefit. SIGNIFICANCE: When an endoscopic examination of the PNS yields normal results, a biopsy is not necessary because the likelihood of disease is low.