Pregnancy and nasopharyngeal carcinoma: a prognostic evaluation of 27 patients

In order to study the influence of pregnancy on the prognosis of nasopharyngeal carcinoma (NPC), we have retrospectively studied 27 patients who either were discovered to be pregnant during radiotherapy (9 patients, herein abbreviated as concurrent group) or became pregnant after treatment (18 patients, herein abbreviated as subsequent group). This material was collected from the 811 NPC patients treated in our hospital from March 1958 to 1972. The results obtained are presented as follows: Concurrent pregnancy had a disastrous effect on the prognosis of NPC patients giving a five year survival of only 11% (1/9). Of the eight patients who died, six did so within one year of the treatment, five of whom died of distant metastases. This fatal outcome was not altered by any measure we instituted. This adverse influence was not observed in the subsequent group, yet the time of gestation seemed to be relevant to the prognosis. Two of the three patients who became pregnant within one year of the treatment died of disease, those who became pregnant beyond the second year after irradiation had the best prognosis. All seven patients who became pregnant after the second year of treatment survived. The frequency of pregnancy did not influence the prognosis of patients if the conception occurred beyond the second year in the subsequent group. All the five patients who gave birth to two, three or even four children survived for more than five years without any evidence of tumor. A total of 21 children were born to the patients of these two groups. They have been followed regularly for 10 to 20 years. No deformity, or retardation in growth or mentality was discovered, nor was there any evidence of radiation tumor or leukemia observed.