Role of Primary and Metastasis Directed Radiotherapy in Metastatic Nasopharyngeal Cancer

Abstract

Background: Role of primary and metastasis directed radiotherapy established for several cancer sites. While it is not yet clarified in metastatic nasopharyngeal cancer (mNPC). Material and method: A research of relevant studies published in the literature through Pubmed between 2000 and 2020 in English language. The following key words used; metastatic nasopharyngeal cancer, role of radiotherapy in metastatic nasopharyngeal cancer, metastasis directed radiotherapy, primary treatment in metastatic nasopharyngeal cancer. Results: Fifteen retrospective studies, one meta-analysis and one randomized controlled trial (RCT) found. All retrospective studies showed a significant overall survival (OS) benefit of primary radiotherapy in addition to induction chemotherapy. This confirmed by RCT and the meta-analysis. Number of metastasis, response to chemotherapy and EBV DNA level could be part of a prognostic scoring system to indicate primary treatment. Conclusion: primary and metastasis directed radiotherapy has a role in metastatic nasopharyngeal cancer. Further RCT are necessary to establish this indication.