Nasopharyngeal carcinoma in pregnancy: A case series and literature review

Nasopharyngeal carcinoma (NPC) in pregnancy presents a therapeutic challenge due to its rarity. We report our management approaches in three such patients. A 37-year-old woman was diagnosed with stage III (T1N2M0) NPC at 18 weeks of gestation. She was treated with antepartum induction chemotherapy and postpartum chemoradiation. She delivered a healthy infant at 37 weeks and is in remission at 2 years. Two other patients (ages, 30 years and 20 years) were diagnosed with stage IVB and III NPC at 27 and 31 weeks of gestation respectively. Both the patients elected to wait until delivery and were subsequently treated with chemoradiation followed by adjuvant chemotherapy. The patients are in complete long-term remission. Thus antepartum induction chemotherapy after the first trimester followed by postpartum chemoradiation may be effective for NPC in pregnancy. This helps avoid radiation induced feto-toxicity. Patients who present in later pregnancy may delay therapy until after delivery.