Wei W I, Sham J S
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
Expert Rev Anticancer Ther. 2001 Jun;1(1):134-41. doi: 10.1586/14737140.1.1.134.
Contemporary imaging with endoscopic examination determines tumor extent and this is reflected in the revised staging system. Radiotherapy remains the primary treatment modality. The use of intensity-modulated radiotherapy aims at enhanced tumor control while reducing adverse effects. Concurrent chemotherapy has shown to improve survival, although its efficacy in endemic regions requires confirmation. Determination of circulating cell-free Epstein-Barr virus DNA might detect early recurrence. For patients who developed recurrence in the neck, surgery provides good salvage. For small tumor in the nasopharynx, good results can be obtained with reirradiation therapy, brachytherapy or surgery. The salvage option depends on the size and location of the tumor as well as the expertise available. The long-term effects of these treatment modalities might be significant.
当代内镜检查成像可确定肿瘤范围，这在修订后的分期系统中有所体现。放射治疗仍然是主要的治疗方式。调强放射治疗的应用旨在增强肿瘤控制，同时减少不良反应。同步化疗已显示可提高生存率，尽管其在流行地区的疗效尚需证实。检测循环游离爱泼斯坦-巴尔病毒DNA可能有助于发现早期复发。对于颈部出现复发的患者，手术可提供良好的挽救治疗。对于鼻咽部的小肿瘤，再程放疗、近距离放疗或手术可取得良好效果。挽救治疗方案取决于肿瘤的大小和位置以及现有的专业技术。这些治疗方式的长期影响可能很大。
