Thrombocytopenia after treatment for nasopharyngeal carcinoma : acomparison of radiotherapy and chemoradiotherapy

Abstract

Nasopharyngeal carcinoma (NPC) arises from the nasopharyngeal epithelium. Radiotherapy is the mainstay for locoregional NPC, while concurrent chemoradiotherapy is standard for advanced locoregional disease. Both modalities can affect hematopoiesis and alter platelet counts, but comparative data on treatment-related thrombocytopenia are limited. We retrospectively reviewed medical records of 66 NPC patients treated at Dr Kariadi General Hospital between 2016 and 2023. Collected variables included age, sex, histopathological type, stage, and platelet counts before and after therapy. Descriptive statistics summarised patient characteristics. Paired T-tests were used to evaluate within-patient changes in platelet count pre- versus post-treatment. The association between treatment modality (radiotherapy vs chemoradiotherapy) and occurrence of thrombocytopenia was assessed using the Chi-Square test. Most patients were male (75.8%) and ≥40 years old (75.8%). WHO type 3 histology comprised 83.3% of cases; stage IVA was the most common stage (42.4%). Mean platelet counts decreased from 364.18 × 103/μL to 248.76 × 103/μL after radiotherapy, and from 390.18 × 103/μL to 209.24 × 103/μL after chemoradiotherapy. Thrombocytopenia occurred in 5/33 patients (15.2%) receiving radiotherapy and 13/33 patients (39.4%) receiving chemoradiotherapy. In this cohort, NPC predominantly affected males ≥40 years with WHO type 3 histology and stage IVA disease. Both radiotherapy and chemoradiotherapy were associated with reductions in platelet count, with a higher observed incidence of thrombocytopenia following chemoradiotherapy. Prospective studies with larger samples are warranted to confirm these findings and to identify risk factors for clinically significant thrombocytopenia.