Combination of Radiotherapy and Nimotuzumab for Locally Advanced Nasopharyngeal Carcinoma: A Case Report

We present a particular case in which nimotuzumab usage as the chemotherapy for locoregionally advanced NPC gives a better outcome for the patient. A 52-year-old woman came with a history of left side stuffiness, rhinorrhea, epistaxis, and hearing loss since 1.5 years ago. She complained about intracranial symptoms such as headaches, tingling sensation, diplopia, and strabismus on the left side of the face for one year before admission. Biopsy of the nasal cavity in July 2018 showed undifferentiated non-keratinizing carcinoma. CT scan showed a mass in the nasopharyngeal cavity without intracranial extension. A pre-therapeutic CT scan in October 2019 showed a massive intracranial extension with midline shift and perifocal edema. She was diagnosed with stage 4a nasopharyngeal carcinoma. The patient received a combination of 35 times radiotherapy and five times administration of Nimotuzumab. A post-therapeutic CT scan showed a loss of nasopharyngeal mass and intracranial sign. The treatment has improved all symptoms with negligible side effects, and Karnofsky’s score is as high as 90. Nimotuzumab showed to give negligible toxicity and is well-tolerated among locally advanced NPC patients. The appropriation of Nimotuzumab in locally advanced NPC with intracranial infiltration was tolerable and showed convincing clinical results.