Survival of Nonmetastatic Nasopharyngeal Cancer Patients Treated Radically by Two Dimensional External Beam Radio Therapy at Tikur Anbessa Specialized Hospital, Radiotherapy Center, Addis Ababa, Ethiopia, 2020: a Retrospective Cohort Study.
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Date
2020-09
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Addis Ababa University
Abstract
Introduction: Globally, an estimated 51,000 deaths from nasopharyngeal carcinoma were reported in 2012. In Africa, 8700 new nasopharyngeal cancer cases and 5500 deaths occurred in 2008. A 22 months median survival was seen in post concurrent chemoradiation Nigerian cases and two year cure rate of 16% was achieved in East African post radiotherapy cases. There are no, however, data on survival of nonmetastatic nasopharyngeal cancer in Ethiopia.
Objective: To examine survival time of non-metastatic nasopharyngeal cancer patients treated radically by concurrent chemoradiation using 2 dimensional external beam radiotherapy at Tikur Anbessa Specialized Hospital, Radiotherapy Center, Ethiopia, 2020.
Methodology: A retrospective cohort study was conducted among all nonmetastatic nasopharyngeal cancer cases treated radically by 2 dimensional external beam radiotherapy from January 2013 to August 2018 at Tikur Anbessa Specialized Hospital, Radiotherapy center. Descriptive and frequency analysis was done to calculate mean, median, standard deviation and percentile. Kaplan meier analysis was used for survival analysis. Bivariate and multivariate cox regression done to assess association between dependent and independent variables. Multicolinearity test (T<0.1, VIF < 10) was assessed among the variables with significant association on multivariate cox regression.
Results: Mean age at diagnosis was 33± 16 years. Most patients (97.1%) presented with locoregionally advanced disease. The median survival was 31 months with 95% CI (27, 35) & overall survival rate of 37.9% after 31 months of median follow up. Patients who took 4 cycles of concurrent chemotherapy were more likely to have longer survival with Crude Hazard Ratio of 0.28, 95% CI (0.11, 0.72). Post treatment recurrence, distant metastasis or bone metastasis were associated with lower survival on multivariate cox regression.
Conclusion/recommendation: Although the median overall survival outcome of our patients (37.9%) was low as compared to most reports of developed countries, it might be acceptable given the higher stages of most patients, technique of treatment delivery & long waiting list for treatment. So, we should design a policy to increase public awareness & expand cancer centers
to increase access to recent treatment modalities.
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Non- metastatic nasopharyngeal cancer, locoregional, patterns of treatments, survival, Tikur Anbessa Specialized Hospital, Ethiopia.