Nasopharyngeal carcinoma

Nasopharyngeal carcinoma (NPC), also known as nasopharyngeal cancer or cavum cancer, is a malignant tumor arising from the epithelial cells lining the nasopharynx — the upper part of the throat behind the nose. It is distinct from other head and neck cancers due to its unique epidemiology, etiology, and clinical behavior. NPC is strongly associated with Epstein-Barr virus (EBV) infection, and genetic susceptibility plays an important role, with associations identified in the HLA region on chromosome 6p21 and other loci. Environmental factors such as consumption of salt-preserved foods containing nitrosamines and tobacco exposure also contribute to risk. The disease primarily affects the nasopharyngeal region and can spread to cervical lymph nodes, which is often the first clinical sign noticed by patients. Key symptoms include a painless neck mass (enlarged lymph nodes), nasal obstruction, epistaxis (nosebleeds), hearing loss or tinnitus due to middle ear effusion, headache, and cranial nerve palsies in advanced cases. Because of its deep anatomical location, NPC is frequently diagnosed at an advanced stage. The World Health Organization classifies NPC into keratinizing squamous cell carcinoma, non-keratinizing carcinoma (differentiated and undifferentiated), and basaloid squamous cell carcinoma, with the non-keratinizing undifferentiated type being most common in endemic regions. NPC is highly sensitive to radiation therapy, which is the primary treatment modality for early-stage disease. For locally advanced disease, concurrent chemoradiotherapy with cisplatin-based regimens is the standard of care, often combined with adjuvant or induction chemotherapy. Immunotherapy, including checkpoint inhibitors targeting PD-1/PD-L1, has shown promise in recurrent or metastatic NPC. The prognosis varies by stage, with five-year survival rates exceeding 90% for early-stage disease but significantly lower for advanced stages. NPC shows a striking geographic distribution, with the highest incidence in southern China, Southeast Asia, and among certain populations of North Africa and the Arctic region.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Nasopharyngeal carcinoma