INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA <p style="text-align: justify;">International Journal of Nasopharyngeal Carcinoma (IJNPC) is a peer review journal that publishes research findings from disciplines related to nasopharyngeal carcinoma. This journal was published by the Center of Excellence Nasopharyngeal Carcinoma Universitas Sumatera Utara, collaborated with TALENTA Publisher Universitas Sumatera Utara. The publication of papers is quarter yearly, published in March, June, September, and December. The journal is purposed to provide international sources of information to doctors and other health professionals who are interested in nasopharyngeal carcinoma. This journal is expected to improve communication between researchers so that it has an impact on the development of knowledge regarding nasopharyngeal carcinoma and stimulates further research related to head and neck surgical oncology, diagnosis, and clinical management.</p> <p style="text-align: justify;">Articles in the International Journal of Nasopharyngeal Carcinoma will be reviewed by experts in the leading nasopharyngeal carcinoma. This journal publishes original research, review articles and case reports. We accept submissions from all over the world. All submitted articles are not in the condition of being submitted to other journals and have never been published elsewhere.</p> TALENTA PUBLISHER en-US INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2656-9027 <div id="coptf"> <p align="justify">The Authors submitting a manuscript do so on the understanding that if accepted for publication, copyright of the article shall be assigned to The International Journal of Nasopharyngeal Carcinoma (IJNPC)<span id="result_box" class="" lang="en"><span class="">&nbsp;as well as TALENTA Publisher Universitas Sumatera Utara</span></span> as publisher of the journal.</p> <p align="justify">Copyright encompasses exclusive rights to reproduce and deliver the article in all form and media. The reproduction of any part of this journal, its storage in databases and its transmission by any form or media, will be allowed only with a written permission from The International Journal of Nasopharyngeal Carcinoma (IJNPC).</p> <p align="justify">The Copyright Transfer Form can be downloaded <a href="" target="_blank" rel="noopener">here.&nbsp;</a><br>The copyright form should be signed originally and sent to<a href=""> the Editorial Office</a> in the form of original mail or scanned document.</p> </div> Analysis Titer of Epidermal Growth Factor Receptor on Nasopharyngeal Cancer Patients Based on Stadium and Histopathological Profile in Dr. Zainoel Abidin General Hospital Banda Aceh <p><strong>Introduction</strong><strong>: </strong></p> <p>Nasopharyngeal carcinoma ranks first in incidence at the head and the neck departement. Epidermal Growth Factor Receptor (EGFR) is a transmembrane tyrosine kinase receptor from the ErbB family. Excess EGFR titer is an indication of a malignant transformation and cell differentiation that can ultimately determine the effectiveness of using anti EGFR drugs nasopharyngeal carcinoma patients.</p> <p><strong>Objective: </strong></p> <p>To determine the EGFR titer of nasopharyngeal cancer tissue based on the stage and histopathological profile in Dr. Zainoel Abidin Banda Aceh.</p> <p><strong>Methods</strong><strong>: </strong></p> <p>Patients with suspected nasopharyngeal carcinoma were subjected to a nasopharyngeal biopsy examination, some samples were sent to the Anatomical Pathology Laboratory of the General Hospital Dr. Zainoel Abidin Banda Aceh for histopathological examination and some were sent to the Research Laboratory of the Faculty of Dentistry, Syiah Kuala University for examination of EGFR titers. This study was conducted from January 2020 to October 2020.</p> <p><strong>Result</strong><strong>s: </strong></p> <p>There were 17 samples of nasopharyngeal carcinoma. Based on the results of the Paired T test analysis, it can be seen that there is a difference in the quantity of EGFR titers of each study subject with the variable stage and histopathological profile. Specifically, the Paired T test analysis between EGFR titers and Stadium (P&lt;0.05; 0.00); and analysis of EGFR titer with histopathological profile (P&lt;0.05; 0.00). In general, the Friedmann test analysis showed that there were significant differences in the incidence of nasopharyngeal carcinoma in patients with regard to age, histopathological profile and stage (P&lt;0.05).</p> <p><strong>Conclusion: </strong></p> <p>EGFR titer quantity has a positive relationship with nasopharyngeal carcinoma stage and there is no relationship between EGFR titer and histopathological profile of nasopharyngeal carcinoma</p> Benny Kurnia Fera Kamila Kemal Basri Abdul Gani Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 1 4 10.32734/ijnpc.v3i01.5723 Association between Lymphocyte Monocyte Ratio and Clinical Staging of Nasopharyngeal Carcinoma <p><strong>Introduction</strong><strong>: </strong></p> <p>Nasopharyngeal cancer (NPC) is the most common head and neck malignancy with an ever-increasing incidence. Inflammatory biomarkers has been proven to be an indicator of immune response against malignancies. A more advanced clinical stage will elicit a worse immune response against tumor cells. A simple and low cost laboratory examination using biomarkers such as lymphocyte monocyte ratio is needed in order to determine the prognosis of NPC patients based on immune response against malignancies.</p> <p><strong>Objective: </strong>To determine the association between lymphocyte monocyte ratio and the clinical stage of patients with NPC.</p> <p><strong>Methods</strong><strong>: </strong></p> <p>A case control study was used on data obtained from medical records of NPC patients who had undergone staging in the Otolaryngology Outpatient Department of Sardjito Public Hospital from 2015 to 2018.</p> <p><strong>Result</strong><strong>s: </strong></p> <p>Total of 64 patients were enrolled in the study, comprising of 38 males (59.4%) and 26 females (40.6%). There were 33 (51.6%) patients aged ≤ 50 years and 31 patients (48.4%) aged &gt; 50 years, with early and advanced clinical stages of 32 patients in each age group. The most common histopathological type is undifferentiated carcinoma (WHO Type 3) (60 patients, 93.7%) followed by non-keratinizing carcinoma (WHO Type 2) (4 patients, 6.3%). The cutoff ratio for lymphocyte monocyte ratio was obtained from ROC Curve analysis, which was 2,64. Statistical analysis using chi-square test showed an association between LMR and clinical staging of NPC patients with a p value &lt; 0,001, with an Odds Ratio of 6.53 (CI 95%; 2.19 – 19.42). Thus, patients with a lower LMR was shown to have 6.53 times the risk of having a more advanced clinical stage compared to higher LMR.</p> <p><strong>Conclusion: </strong></p> <p>There was found to be an association between lymphocyte monocyte ratio and clinical staging of nasopharyngeal cancer patients</p> Heribertus Diwyacitra Aribawa Bambang Hariwiyanto Sagung Rai Indrasari Danu Yudistira Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 5 8 10.32734/ijnpc.v3i01.5729 Differences of Mean Platelet Volume (MPV) Value Among Clinical Stage of Undifferentiated Type Nasopharyngeal Carcinoma Patient at ORL-HNS Outpatient, Sanglah General Hospital Denpasar <p><strong>Introduction</strong><strong>: </strong></p> <p>Measurement of the mean platelet volume (MPV) is a simple, inexpensive, useful, easy to apply test without additional costs. A high MPV value indicates the presence of large and active platelets in the peripheral blood vessels. Increased MPV value can be a biomarker of nasopharyngeal carcinoma (NPC) malignancies as well as a warning of the risk of thrombosis in malignancy.</p> <p><strong>Objective: </strong></p> <p>To investigate the differences of mean platelet volume (MPV) value among clinical stage of undifferentiated type nasopharyngeal carcinoma (NPC) patient at ORL-HNS outpatient, Sanglah General Hospital Denpasar.</p> <p><strong>Methods</strong><strong>: </strong></p> <p>A cross-sectional study with 30 undifferentiated types of NPC patient in ORL-HNS outpatient at Sanglah Hospital Denpasar from January 2017 to December 2019. The sample was selected by systematic random sampling. The analysis used the ANOVA difference test to determine the difference in MPV values among the clinical stage of the undifferentiated type of NPC patient.</p> <p><strong>Result</strong><strong>s: </strong></p> <p>In this study, the mean age of NPC patients was 50.70 with a standard deviation of 12.55 with the most NPC patients were found to be at the age of more than 50 years. The proportion of NPC patients based on sex was found more in men with 19 patients (63.3%). The mean of MPV value was 12.40 with a standard deviation of 1.27. The highest distribution of undifferentiated types NPC patients among the clinical stage, at stage III and IVA, with 12 patients (40%). The MPV values among clinical stage in patients with undifferentiated type of NPC is significantly different with P= 0.012.</p> <p><strong>Conclusion: </strong></p> <p>In this study there was a significant difference between the MPV value among the clinical stage of the undifferentiated type of NPC in ORL-HNS Outpatient, Sanglah General Hospital with P= 0.012</p> I Gede Wahyu Adi Raditya I Ketut Suanda Agus Rudi Asthuta Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 9 12 10.32734/ijnpc.v3i01.5726 Nasopharyngeal Carcinoma with a Complication of Facial Nerve Paresis <p><strong>Introduction</strong><strong>: </strong></p> <p>One fifth of NPC patients have cranial nerve involvement at the time of diagnosis. The nearby location of rossenmuller fossa to lacerum foramen and middle base of the cranium provide way for tumor to extent directly to the cranium and adjacent cranial nerve. Facial palsy due to NPC does not happen very often, with incidence only compromise less than 1% of all cases.</p> <p><strong>Case report: </strong></p> <p>We reported a case of a 42 years old female with a complaint of blood stain rhinorea, mass in the nasopharynx, and facial assymmetry. Based on his history of illness, physical examination, imaging, and histopathology, the working diagnosis was Nasopharyngeal Carcinoma Stage IVA (T4 N0 M0) with facial nerve paresis (Hause-Brackmann V). The intervention done for the patient was radiotherapy. </p> <p><strong>Conclusion: </strong></p> <p>The patient refused to undergo chemotherapy, so the only therapy done in this case was radiotherapy. After undergoing 35 cycles of radiotherapy, a fair improvement was seen clinically on the patient</p> Nova Audrey Luetta Pieter Adi Matra Prawira Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 13 16 10.32734/ijnpc.v3i01.5608 Neck Residue of Nasopharyngeal Carcinoma (NPC): Timing of Diagnosis and Treatment <p><strong>Introduction</strong><strong>: </strong></p> <p>Prognosis of patients with NPC has improved but the risk of persistence regional of disease is still a critical problem. Timing of diagnosis the condition along with immediate yet appropriate treatment should be considered.</p> <p><strong>Case report: </strong></p> <p>Female 35 year-old diagnosed with NPC T2N3M0 and had finished neo-adjuvant chemotherapy (NAC) continued with chemoradiation (CRT) from July until December 2020. Clinical follow up on January 2021 showed palpable and fixated lymph node at level V of right neck sized 3x3x2.5 yet no mass identified at nasopharynx area. Patient was clinically diagnosed as neck residue of NPC and further management choices between early neck dissections or adjuvant chemotherapy (AdjCT) was still debatable in the multidisciplinary team discussion. </p> <p><strong>Conclusion: </strong></p> <p>Neck residue diagnosis for high risk features of NPC should be made early. Immediate appropriate treatment should be considered since its associated with prognosis and overall survival of NPC patient</p> Ferucha Moulanda Marlinda Adham Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 17 19 10.32734/ijnpc.v3i01.5585 Radiotherapy with Neoadjuvant Chemotherapy on Nasopharyngeal Carcinoma (NPC) Advanced Stage <p><strong>Introduction</strong><strong>: </strong></p> <p>Nasopharyngeal carcinoma (NPC) frequently occurs in Indonesia which is endemic to several countries of Asia, specifically in southeastern China, and is associated of infection with Epstein-bar virus (EBV). In recovery, radiation therapy plays a vital role. Chemotherapy will increase the local control rate/disease control rate (DCR) in cases with an advanced local stage.</p> <p><strong>Case report: </strong></p> <p>A 49-year-old man felt a lump in his neck accompanied by ringing in his ears and sore throat. Physical examination showed a tumor in the right nasopharynx enlarged into the parapharynx cavity and closed Rosenmuller's fossa. The results of the biopsy were positive for non-keratinized, undifferentiated (WHO-3) type A nasopharyngeal carcinoma (NPC), moderate malignancy. The planned treatment consists of a combination of chemotherapy and radiotherapy. Chemotherapy is given 3 cycles before radiotherapy (neo adjuvant) and 3 cycles of concurrent radiotherapy (adjuvant). The total dose of radiotherapy given was 6,600 c Gy and supra clavicle 5,400 c Gy with fractionation of 33 times in the tumor and 27 times in the supra clavicle. </p> <p><strong>Conclusion: </strong></p> <p>The results presented 6 months after radiotherapy were complete response to loco regional tumors with well tolerated side effects.</p> Robertus Suryoseto Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 20 24 10.32734/ijnpc.v3i01.5576 Carboplatin and Docetaxel Chemotherapy in Nasopharyngeal Carcinoma: A Case Report <p><strong>Introduction: </strong></p> <p>Nasopharyngeal Carcinoma (NPC) is a squamous cell malignant tumor that usually occurs in the lateral wall of the nasopharynx near the area of the eustachian tube. NPC is often found in southern Asia. In head and neck areas, NPC is one of the top five malignant which has the highest frequency tumours in Indonesia.</p> <p><strong>Case</strong><strong> report: </strong></p> <p>We reported a case of a 57-year-old man with complaints of obstruction in both noses, accompanied by headache. Based on medical history, physical and Radiology examination, we concluded that he was diagnosed with Nasopharyngeal Carcinoma WHO II Stage III (T3N0M0). Histopathology revealed a differentiated non keratinizing squamous cell carcinoma in the nasopharynx. Six cycles of carboplatin and docetaxel regimen as an induction chemotherapy were planned for this patient. The patient then performed a nasoendoscopy followed by nasopharyngeal CT scan evaluation and showed a good response after Chemotherapy.</p> <p><strong>Conclusion:</strong></p> <p>Carboplatin and docetaxel chemotherapy management in this patient was given according to the management of nasopharyngeal carcinoma and has given a good response to the patient</p> Denny Satria Utama Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 25 27 10.32734/ijnpc.v3i01.5725 Young Woman with Early Stage Nasopharyngeal Carcinoma: A Rare Case <p><strong>Introduction: </strong></p> <p>Nasopharyngeal carcinoma (NPC) is the most often cancer occurs in the head and neck. Early stage NPC is difficult to diagnose clinically, most NPC patients have been diagnosed in advanced stages. The study presents a case of early-stage NPC with the symptoms of recurrent nosebleeds and headache which can be early symptom to suspect NPC.</p> <p><strong>Case report: </strong></p> <p>We reported a case of 27-year-old woman patient with chief complaints recurrent nosebleeds since 2 months ago frequently one to two times a week. Patients also complained of mild headaches, but getting better by taking a rest and patient also had a history of tinnitus since 2 month ago. The patient has a habit of consuming salted fish and preservative food since childhood. Based on his history of illness, physical examination, imaging, and histopathology, we concluded that he was diagnosed with Nasopharyngeal Carcinoma T1N0M0, and the patient are going to reffered to North Sumatera or central java to get radiotherapy.</p> <p><strong>Conclusion</strong><strong>:</strong></p> <p>Early stage of nasopharyngeal cancer is a rare condition at Aceh, the fastest we found early stages will increased survival rate.</p> Benny Kurnia Fadhlia Lily Setiani Juniar Ridha Chaharsyah Mulya Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 28 30 10.32734/ijnpc.v3i01.5728 Computed Tomography (CT) Finding on Nasopharyngeal Carcinoma <p><strong>Introduction</strong><strong>: </strong></p> <p>Nasopharyngeal carcinoma (NPC) is cancer come from nasopharynx epithelium. Nasopharyngeal carcinoma is a frequent cancer in Indonesia and in the fifth position for the most common tumor and first position for the most common malignancy in the head and neck. The signs and symptoms of nasopharyngeal carcinoma can be unspecific. Radiological examination of suspect NPC is an important diagnostic investigation. Staging of nasopharyngeal carcinoma is based on the analysis of the primary tumor, lymph node involvement, and the status of distant metastasis (M category).</p> <p><strong>Case report:</strong> </p> <p>We reported three patients with nasopharyngeal carcinoma in Adam Malik General Hospital that was diagnosed by histopathology biopsy and undergo Nasopharynx Computed tomography (CT) examination. The study aimed to present CT findings of the patients.</p> <p><strong>Conclusion: </strong></p> <p>Imaging modalities include contrast enhanced computed tomography (CT) has been used for staging and evaluation. The main objective of the radiological examination are provide a more definite diagnosis of suspected tumor in the nasopharynx., determine the more precise location of the tumor, determine the size of the tumor, and finding and determine the extent of the spread of the tumor to the surrounding tissue, where extensive invasion can be found as anteriorly, lаterаlly, posteriorly, inferiorly, and superiorly</p> Elvita Rahmi Daulay Copyright (c) 2021 INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA 2021-03-20 2021-03-20 3 01 31 35 10.32734/ijnpc.v3i01.5553