Management of the nasopharyngeal cancer in the oncology department of the uhc/jra (Madagascar)

Nasopharyngeal cancer (NPC) is uncommon in Sub-Saharan Africa, particularly in Madagascar. Radiotherapy is the main definitive treatment of this cancer. In our country, most patients did not have access to treatment because the radiotherapy machine did not exist during the study period. The aims of this study were to report the cases of NPC seen in the oncology department of the University Hospital Center Joseph Ravoahangy Andrianavalona (UHC/JRA) during the period from January 2009 to December 2013, to discuss the proposed treatments and to demonstrate the value of radiation treatment in the management of the patients. This was a descriptive and retrospective review of patient folder. Ninety seven cases of head and neck (H&N) cancer were recorded; we have studied 7 patients with NPC. The annual incidence was 0.3%. The ages of the patient were between 20 to 62 years old and the sex ratio 1.33. Nasal obstruction and epitaxis were the first troubles recognized by the patients. Our patients did not screen for viral investigation. Six patients had T4 and N2 classification AJCC and one patient with metastasis. Only chemotherapy was done for the cure. Cisplatin-Fluorouracil (CDDP-FU) and Adriblastina-Cisplatin (AC) were used. The recurrences appeared within the six months after the last cycle of chemotherapy and death within the year of the patient management. The oncology department of the UHC/JRA found a big challenge to treat the patients who needed radiation. They only gave chemotherapy to their patients. The outcome of this type of treatment is clearly questionable in the management of the NPC in advanced stage.