Nazofarenks Kanseri
Özet
Nazofarenks karsinomu epidemiyoloji, histoloji, doğal seyir ve tedaviye yanıt açısından diğer baş boyun skuamöz hücreli karsinomlarından farklıdır. Belirgin coğrafi dağılımla karakterizedir. Özellikle doğu ve güneydoğu Asya’da yaygındır. Geçtiğimiz on yılda insidansında belirgin azalma olduğu, ölüm oranlarının önemli ölçüde azaldığı gösterilmiştir. Bu azalmanın yaşam tarzı değişiklikleri, görüntüleme tekniklerinde gelişme, patogenez ve risk faktörleri hakkında daha bilinçli olunması ve kişiye özel kemoradyoterapi stratejilerinin gelişmiş olmasına bağlanmıştır. Özellikle plazma Epstein-Barr virüsü (EBV) DNA‘sı taramasının endemik bölgelerde daha sık yapılması önemli etken olarak bulunmuştur. Nazofarenks kanseri lenf nodlarına metastaz yapma oranı yüksek bir kanserdir. Cerrahi tedaviye uygun olmayan bölgesi itibariyle primer tedavinin kemoradyoterapi olduğu bir kanserdir. Ölüm oranlarındaki azalmalar özellikle yakın ve sıkı takip ile tedavi seçeneklerine kısa sürede ulaşıyor olabilmekle ilgili bulunmuştur. Bu hastalarda tedavi sonrasında bilgisayarlı tomografi, manyetik rezonans görüntüleme gibi çeşitli radyolojik görüntülemeler ve muayene ile yakın takip hastalık nüksünü erken tespit etmek için çok önemlidir. Takipte ilk 2 yıl nükslerin en sık görüldüğü dönem olduğu için yakın takip çok önemlidir. Bu dönemde hastaların 2-3 ayda bir sistemik ve hastalık bölgesi muayenesi ile biyokimya hemogram parametreleri ve görüntülemeler ile taranması önerilmektedir.
Nasopharyngeal carcinoma differs from other squamous cell carcinomas of the head and neck in terms of epidemiology, histology, natural history and response to treatment. It is characterized by a distinct geographical distribution. It is especially common in east and southeast Asia. In the past decade, it has been shown that its incidence has decreased significantly and mortality rates have decreased significantly. This decrease has been attributed to lifestyle changes, improvement in imaging techniques, increased awareness of pathogenesis and risk factors, and the development of personalized chemoradiotherapy strategies. In particular, more frequent plasma Epstein-Barr virus (EBV) DNA screening in endemic areas has been found to be an important factor. Nasopharyngeal cancer has a high rate of metastasis to lymph nodes. It is a cancer for which chemoradiotherapy is the primary treatment due to its region that is not suitable for surgical treatment. Reductions in mortality rates have been found to be related to the ability to access treatment options in a short time, especially with close and strict follow-up. In these patients, close follow-up with various radiological imaging studies such as computed tomography, magnetic resonance imaging and examination after treatment is very important for early detection of disease recurrence. In the first 2 years of follow-up, close follow-up is very important as this is the period in which relapses are most common. In this period, it is recommended that patients be screened every 2-3 months with systemic and disease site examinations, biochemistry, hemogram parameters and imaging.
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