In nasopharyngeal carcinoma (NPC), the EBV-associated subtype with the best response to chemoradiotherapy and most favourable prognosis is:

• A Type 1 (WHO) — keratinising squamous cell carcinoma
• B Type 2 (WHO) — non-keratinising differentiated carcinoma
• C Type 3 (WHO) — undifferentiated carcinoma (lymphoepithelioma) ✓
• D Type 1 and 3 have equal prognosis

Explanation

WHO Type 3 NPC (undifferentiated carcinoma, previously called lymphoepithelioma) is strongly associated with Epstein-Barr virus infection, is most radiosensitive, and has the best prognosis among NPC subtypes when treated with platinum-based chemoradiotherapy. It is endemic in South-East Asia, North Africa, and southern China. WHO Type 1 (keratinising SCC) is least associated with EBV, has the worst prognosis, occurs in older Western patients, and behaves like typical head and neck SCC with poorer chemoradiosensitivity. Type 2 is intermediate.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.