Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy.
Anticancer Res. 2014 Sep;34(9):5075-8.
Nasopharyngeal carcinoma (NPC) is uncommon in the Western hemisphere and in Europe. The undifferentiated subtype has a relevant propensity to metastasize systemically, mostly in the skeleton. In patients with distant metastasis at presentation there is no consensus on the most appropriate approach.
Evaluation of a young patient with initially bony metastatic nasopharyngeal cancer treated with platinum-based induction chemotherapy followed by radiotherapy (performed with Tomotherapy) combined to chemotherapy on primary region with curative intent, and subsequent focal irradiation of the bone metastasis.
After 27 months from the end of the planned treatment the patient has not shown any late toxicity or complications in the treated areas and is without any evidence of progression. It seems appropriate to treat selected metastatic patients with a radical intent, using induction chemotherapy followed by radical chemoradiotherapy on the primary region and high dose radiation on the metastasis. Moreover, Tomotherapy demonstrated a tolerable grade of acute toxicity without any relevant late complications.
鼻咽癌（NPC）在西半球和欧洲并不常见。未分化型鼻咽癌具有很强的全身转移倾向，主要转移至骨骼。对于初诊时即发生远处转移的患者，目前尚无最佳治疗方法的共识。
评估了一位年轻患者，其初诊时表现为骨转移的未分化型鼻咽癌，给予顺铂为基础的诱导化疗，随后行根治性放化疗（采用 Tomotherapy 技术），同时针对原发肿瘤区域进行化疗，之后对骨转移灶进行局部放疗。
计划治疗结束后 27 个月，患者在治疗区域未出现任何晚期毒性或并发症，且无进展迹象。对于选择的转移性患者，采用诱导化疗，随后对原发肿瘤区域行根治性放化疗，并对转移灶行高剂量放疗，似乎是一种根治性的治疗策略。此外，Tomotherapy 显示出可耐受的急性毒性，无明显的晚期并发症。
