Improved Overall Survival Due to Reduced Waiting Time in Nasopharyngeal Cancer Patients Treated with Chemoradiotherapy in Yogyakarta, Indonesia

Document Type : Research Articles

Authors

1 Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, The Netherlands.

2 Department of Radiation Oncology, Dr. Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia.

3 Department of Surgical Oncology, the Netherlands Cancer Institute, Amsterdam, The Netherlands.

4 Department of Head and Neck, Curaçao Medical Center, Curaçao.

5 Department of Head and Neck, Dr. Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia.

6 Department of Medical Oncology, the Netherlands Cancer Institute, Amsterdam, The Netherlands.

Abstract

Background: In Indonesia, nasopharyngeal carcinoma (NPC) is highly prevalent and is one of the leading causes of cancer-related mortality. Lower overall survival (OS), compared to neighboring countries, is associated with a prolonged waiting time (WT) and overall radiotherapy (RT) treatment time (OTT). In 2018, the RT department of the Dr. Sardjito Hospital in Yogyakarta, Indonesia, increased the number of treatment machines and clinical staff. This may have led to an improvements in WT and OTT. Therefore, we analyzed a recent cohort of NPC patients to evaluate the outcomes in light of these changes. Materials and Methods: A retrospective cohort of 229 NPC patients underwent chemoradiotherapy with curative intent between January 2018 and December 2021. The majority had locally advanced NPC. The turning point was in 2018, marking a pivotal year. Consequently, the years 2019-2021 were compared with 2018. Endpoints included WT, OTT, OS, as well as locoregional control (LRC) and disease-free survival (DFS). Results: The mean follow-up time was 16.9 months. For all patients, the median WT and OTT were 110 days and 50 days. Comparing 2018 with 2019-2021, the WT differed significantly with 190 versus 97 days (p<0.001) while the OTT, 53 versus 50 days, was borderline different (p=0.049). The 2-year OS significantly improved from 42.6% in 2018 to 60.5% among patients treated between 2019-2021 (p=0.042). Conclusion: In conclusion, this study analyzed the impact of WT and OTT on outcomes for NPC patients undergoing chemoradiotherapy at Dr. Sardjito Hospital. A significant decrease in WT of 97 days was observed when compared to 2018. However, the limited availability of advanced imaging likely resulted in an underestimation of distant metastases, leading to a 2-yr OS of 60.5%. Better staging methods, as well as improved awareness of NPC, are crucial for better treatment decisions and improving future patient outcomes.

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Asian Pacific Journal of Cancer Prevention
Volume 27, Issue 1
January 2026
Pages 201-208

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History

  • Receive Date: 02 June 2025
  • Revise Date: 04 September 2025
  • Accept Date: 15 January 2026

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