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Nasopharyngeal carcinoma: United Kingdom National Multidisciplinary Guidelines

Lookup NU author(s): Dr Max RobinsonORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. Although much commoner in the eastern hemisphere, with an age-standardised incidence rate of 0.39 per 100 000 population, cancers of the nasopharynx form one of the rarer subsites in the head and neck.(1) This paper provides recommendations on the work up and management of nasopharyngeal cancer based on the existing evidence base for this condition.RecommendationsPatients with nasopharyngeal carcinoma (NPC) should be assessed with rigid and fibre-optic nasendoscopy. (R)Nasopharyngeal biopsies should be preferably carried out endoscopically. (R)Multislice computed tomographic (CT) scan of head, neck and chest should be carried out in all patients and magnetic resonance imaging (MRI) where appropriate to optimise staging. (R)Radiotherapy (RT) is the mainstay for the radical treatment for NPC. (R)Concurrent chemoradiotherapy offers significant improvement in overall survival in stage III and IV diseases. (R)Surgery should only be used to obtain tissue for diagnosis and to deal with otitis media with effusion. (R)Radiation therapy is the treatment of choice for stage I and II disease. (R)Intensity modulated radiation therapy techniques should be employed. (R)Concurrent chemotherapy with radiation therapy is the treatment of choice for stage III and IV disease. (R)Patients with NPC should be followed-up and assessed with rigid and/or fibre-optic nasendoscopy. (G)Positron emission tomography-computed tomography (PET-CT), CT or MRI scan should be carried out at three months from completion of treatment to assess response. (R)Multislice CT scan of head, neck and chest should be carried out in all patients and MRI scan whenever possible and specially in advanced cases with suspected recurrence. (R)Surgery in form of nasopharyngectomy should be considered as a first line treatment of residual or recurrent disease at the primary site. (R)Neck dissection remains the treatment of choice for residual or metastatic neck disease whenever possible. (R)Re-irradiation should be considered as a second line of treatment in recurrent disease. (R)

Publication metadata

Author(s): Simo R, Robinson M, Lei M, Sibtain A, Hickey S

Publication type: Article

Publication status: Published

Journal: Journal of Laryngology & Otology

Year: 2016

Volume: 130

Issue: Suppl. 2

Pages: S97-S103

Print publication date: 26/05/2016

Online publication date: 12/05/2016

Acceptance date: 02/04/2016

Date deposited: 12/04/2017

ISSN (print): 0022-2151

ISSN (electronic): 1748-5460

Publisher: Cambridge University Press


DOI: 10.1017/S0022215116000517


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