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International Journal of Nasopharyngeal (IJNPC) Vol. 03, No. 02, June 2021 | 45-47

International Journal of NASOPHARYNGEAL CARCINOMA

Journal homepage: https://talenta.usu.ac.id/IJNPC

Covid-19 Vaccination in Nasopharyngeal Carcinoma Patients during COVID-19 Pandemic Irnanda Warda Rizki Nasution1*, Farhat Farhat1, Elvita Rahmi Daulay2 1Departement of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia 2Departement of Radiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia Abstract Article Info Introduction: Nasopharyngeal carcinoma (NPC) is one kind of that is the most common type of head Article history: and neck , arising from the posterior and lateral parts of the nasopharynx especially from torus Received: 7th June 2021 tubarius or pharyngeal recess or the other name is Rosenmüller fossa. This shows significant differences from Received in revised form: 16th June 2021 other head and neck , clinical behavior, cause, , treatment, as well as prognosis. Clinical Accepted: 17th June 2021 trials of COVID-19 vaccines with better follow-up will provide useful data on vaccine advantages in patients receiving cancer treatment, due to the absence of complete data to determine the relationship between active Keywords: treatment and the power to induce immunity to COVID-19 using the vaccine. Nasopharyngeal carcinoma, vaccination, Covid- Discussion: The primary aim of vaccines is to produce stimulation by the antigen we desire in the presence of 19, Adam malik sufficient to elicit memory immunity with tolerable protection. Due to the increasing frailty of cancer patients with infection as well as deaths from COVID-19, there is an urgent need to vaccinate patients with *Corresponding author: COVID-19 cancer. Various considerations for the protection and benefits that are expected to have an effect Address: Jl. Dr. Mansyur No.5, Padang Bulan, with treatment due to their standart management and changes in the immune system of patients with Kec. Medan Baru, Kota Medan, Sumatera Utara . 20155, Indonesia Conclusion The COVID-19 vaccine, granted approved or permitted, will be considered the basic of prevention of this COVID-19 pandemic for patients with nasopharyngeal carcinoma. There are advantages and e-mail: [email protected] disadvantages about Covid-19 vaccine. Then, a quality direction on clinical trials of patients with cancer and COVID-19 vaccines becomes very attractive. Finally, comprehensive oncological care requires cancer patients to be prioritized for the COVID-19 vaccine.

1. INTRODUCTION 2. MAIN TEXT Nasopharyngeal carcinoma (NPC) is one kind of cancer that is the most Immunity of humoral and immunity of cell mediated are immunity to common type of head and neck malignancy, arising from the posterior and lateral guard ourselves of viral . Humoral immunity is immunity through parts of the nasopharynx especially from torus tubarius or pharyngeal recess or B lymphocytes that producing antibody and may also additionally neutralize the other name is Rosenmüller fossa. This shows significant differences from through binding the viral and stopping the access into host cells. other head and neck cancers, clinical behavior, cause, epidemiology, treatment, Immunity of Cell mediated consists of CD8+ cytotoxic T lymphocytes and as well as prognosis. A sum of morbidities was about 129,000 and mortalities macrophages, which delete cells which is infected by the virus. The were 73,000 reported in 2018 in the world. And rarely found in the Europe or generation of notably efective antibody responses and memory was help by USA. Nasopharyngeal carcinoma is endemic in North , Southeast , the CD4+ T lymphocytes which support to make the B and CD8+ T cells and Arctic, has a relationship with viral infection of EBV (Epstein–Barr virus). become active. The immunity of opsonizing and cell-mediated is helped by According to classification of World Health Organization—WHO, the IgG antibody CD4+ helper T cell subsets consist of T1, and T2 which Nasopharyngeal cancer with the kind of histopathology undifferentiated will enables Immunoglobulin E antibody and allergic-kind inflammation. nonkeratinizing (type III) is the most dominant [1, 3]. On repeat infection, the host’s immune responses will be recalled by The COVID-19 pandemic due to viral infection of agent SARS CoV-2 antigen-specific memory B and T cells will stay persist. (Severe acute respiratory syndrome -2) with the primary pronounced Those protecting immune responses are began out via way of means of outbreak in in 2019 back then. It was found into an excessive quantity expert antigen- presenting cells (APC) in viral infections, which is include withinside the mucosa of the upper [4]. An increased risk of dendritic cells, it is the cell which process, capture, and show withinside the contamination is affecting on all head and neck surgeons when giving treatment secondary lymphoid tissues there are the peptides of virus to the molecules to the patients with Nasopharyngeal Carcinoma. The public is concern over the of MHC to prime naïve antigen-specific T cells. Active T cell priming increase in the equipment of personal protective for the health workers (doctors, frequently calls for extra stimulatory cytokines also co-stimulatory nurses and care givers) as the number of confirmed COVID-19 cases grows a lot molecules. The primary aim of vaccines is to produce stimulation by the higher [5]. antigen we desire in the presence of sufficient infection to elicit memory Until now, information about the strength of COVID-19 vaccination in immunity with tolerable protection. Qualified immunogenic vaccines patients with nasopharyngeal carcinoma is very limited. On the 43,540 subjects require adjuvants and/or a "high-boost" method of multiple doses to produce was going through vaccine trial in of the BNT162b2 mRNA, 3.7% had been higher immune responses [10]. pronounced to have malignancy, with 5 patients developed COVID-19 disease one in the vaccine arm and four in the placebo arm; ref. 30 was at the time of 2.1 The Advantages and Disadvantages of COVID-19 Vaccine reporting. Other trials on the COVID-19 vaccine with higher follow-up will display beneficial records on the advantages of the vaccines in patients who Until now, the rremarkable of the 66 COVID-19 vaccines currently in received different cancer management, however, having not complete clinical trials, 10 vaccines are permitted with limited vaccine use. The table information to know the relations about management of active malignancy and below shows some of the strength and weakness of the Covid-19 vaccine the strength to raise the immunity against COVID-19 using vaccine. [6]. It is (Table 1) [11, 12]. shown that COVID-19 vaccines could leave higher levels to neutralize the antibodies than the infection of SARS-CoV2 in a large number of subjects [7, 8]. It will be very important to offer priority vaccination for patients with cancer who are receiving the which is cytotoxic. Patients with cancers have not very strong immune responses to COVID-19 on current data [9].

Copyright © International Journal of Nasopharyngeal Carcinoma Published by Talenta Publisher, ISSN: 2656-9027 e-ISSN: 2656-9035 DOI: 10.32734/ijnpc.v3i02.6323 45

International Journal of Nasopharyngeal Carcinoma (IJNPC) Vol. 03, No. 02, June 2021 | 45-47

pneumococcal polysaccharides, and inactivated [34]. Indeed, with one exception during periods of intensive cytotoxic chemotherapy, patients undergoing chemotherapy are expected to produce a protective response with COVID-19 vaccination.

2.4 Review for patients given Radiotherapy

Radiotherapy is the treatment needed for people with cancer in the healing or palliative phase. Until now we know that the effects of radiation will affect a large part of the human body and can affect the bone marrow. It is very infrequent that radiotherapy has a valuable effect on immunity to a factor for which vaccination is no longer allowed. The patient's preferred body condition for radiation to enhance the formation of immune cells is in terms of how much total body radiation (TBI) is given to suppress the marrow previous to transplantation of stem cell or some other condition in which the patient receives spine or lymph node irradiation. Indeed, patients Picture 1. Table of the strength and weakness of Covid-19 vaccine [15]. were going through radiotherapy should be allowed to have a protective immune response to the COVID-19 vaccine.

2.2. Implications for Patient with Nasopharyngeal Carcinoma 3. CONCLUSION

The COVID-19 vaccine, granted approved or permitted, will be It is found in patients with malignancy, they are at high risk of considered the basic of prevention of this COVID-19 pandemic for patients developing severe disease due to COVID-19 [29]. From a study conducted with nasopharyngeal carcinoma. There are advantages and disadvantages in the about 73 million subjects, and found that 273,000 about Covid-19 vaccine. Then, a quality direction on clinical trials of patients were diagnosed with malignancy last year and 16,570 patients patients with cancer and COVID-19 vaccines becomes very attractive. diagnosed with COVID-19, patients with malignancy have a very high risk Finally, comprehensive oncological care requires cancer patients to be of being infected with COVID-19. -19 ((aOR ) adjusted odds ratio of 7;). In prioritized for the COVID-19 vaccine. this case, the highest chance of infection was found for patients with blood malignancies, namely (aOR 7.7), non-Hodgkin's (aOR 8.5) and leukemia (aOR 12.2), The mortality rate was also increase in REFERENCES patients with malignancies which could increase the risk of contracting COVID-19. Conluded, patients with malignancies and COVID-19 had a [1] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. higher risk of death (14.9%) than patients with COVID-19 without Global cancer statistics 2018: GLOBOCAN estimates of incidence malignancies (5.3 %) and patients with malignancies without COVID-19 and mortality worldwide for 36 cancers in 185 countries. CA: a cancer (4.0%) [13]. Also, in patients who had a diagnosis of hematological cancer journal for clinicians. 2018 Nov;68(6):394-424. 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International Journal of Nasopharyngeal Carcinoma (IJNPC) Vol. 03, No. 02, June 2021 | 45-47

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