Nasopharyngeal Cancer: Complete Response at One-Year Follow-Up

A personalised treatment journey for a 52-year-old woman from Makassar, Indonesia.

A 52-year-old woman came to me for a second opinion after being diagnosed with nasopharyngeal cancer that had spread to a single site in her spine. She had been advised to receive chemotherapy but delayed treatment because she was concerned about its side effects.

Finding a treatment approach she could accept

Chemotherapy remains a backbone of treatment for metastatic nasopharyngeal cancer. However, she remained reluctant to receive intravenous chemotherapy.

After discussing the available options, expected benefits and risks, I offered an individualised approach using oral chemotherapy combined with intravenous immunotherapy.

She received three cycles, and her tumour shrank.

Radiotherapy using ETHOS with HyperSight

Following this initial response, I delivered radical-dose radiotherapy to the nasopharynx and neck using ETHOS with HyperSight technology over 35 fractions.

Because she had a solitary spinal metastasis, I also treated that site with stereotactic body radiotherapy (SBRT) over three fractions.

Treatment subsequently continued with oral chemotherapy and intravenous immunotherapy as maintenance therapy.

Complete response at one year

At her one-year follow-up assessment, she had achieved a complete response.

She tolerated treatment well overall and continues to live her life with minimal residual radiation toxicity.

The three scan comparisons show the scans before treatment on the left and the one-year follow-up scans on the right.

The previously prominent tracer uptake at the involved head and neck sites has markedly resolved. PET/CT findings are assessed alongside the full scan report and clinical evaluation. Normal tissues can also take up tracer, so colour alone does not determine whether cancer is present or absent.

Personalised care with quality of life in mind

Throughout her treatment, she did not receive intravenous chemotherapy. She did receive oral chemotherapy, intravenous immunotherapy and radiotherapy.

Her treatment plan considered the extent of her disease, her preferences, treatment response and tolerability.

For me, personalised cancer care means finding a clinically appropriate approach that a patient can accept and continue, while maintaining close follow-up and attention to quality of life.

Dr Malwinder Singh — The Bald Oncologist