A 52-year-old man is diagnosed with Stage II nasopharyngeal carcinoma, histologically undifferentiated non-keratinising type, with no distant metastasis. The MAINSTAY of definitive treatment is:

• A Radical surgical excision of the primary tumour
• B Endoscopic debulking followed by observation
• C Chemotherapy alone until response, then reassessment
• D Radiotherapy to the nasopharynx and neck ✓

Explanation

NPC is highly radiosensitive, and because the site is surgically inaccessible and the disease drains early to cervical nodes, radiotherapy covering the nasopharynx and both sides of the neck is the standard primary treatment for localised disease; locally advanced stages add concurrent chemotherapy. Surgery is reserved for persistent or recurrent nodal disease and selected recurrences. Chemotherapy alone is never definitive, which eliminates option C.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.