Almobarak Abdulaziz A, Jebreel Alaeddin B, Abu-Zaid Ahmed
Otolaryngology, Alfaisal University College of Medicine, Riyadh, SAU.
Otolaryngology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.
Cureus. 2019 Mar 9;11(3):e4210. doi: 10.7759/cureus.4210.
Nasopharyngeal carcinoma (NPC) is the most frequent malignancy arising in the nasopharynx. NPC, to a larger degree, substantially differs from the other malignancies of the head and neck, in terms of incidence, etiology, risk factors, molecular pathogenesis, clinical behavior, management and prognosis. Fundamentally, the management of NPC is entirely guided by the disease stage. Favorably, patients with early- stage disease have encouraging survival outcomes with stand-alone radiation therapy (RT), specifically following the emergence of intensity-modulated RT (IMRT). The reported five-year local control rates are outstanding, and they range from 70% to 90%. Unfortunately, around one-third (30%) of patients presents with loco-regional or distant recurrences, despite rigorous curative treatment in the intermediate (stage II) and advanced (stage III-IVB) NPC disease. At the present time, the management of recurrent and metastatic NPC is largely discouraging and presents significant challenges to the treating physicians. Broadly speaking, there are three management schemes utilized in the management of recurrent and metastatic NPC, namely: (i) palliative systemic chemotherapy, (ii) molecular targeted therapy, and (iii) immunotherapy. The goal of this study is to holistically review the existing body of literature on the utility and safety of molecular targeted therapy in the management of patients with recurrent and metastatic NPC, with a special focus on vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) targets.
鼻咽癌（NPC）是鼻咽部最常见的恶性肿瘤。在发病率、病因、危险因素、分子发病机制、临床行为、治疗和预后等方面，鼻咽癌在很大程度上与头颈部的其他恶性肿瘤有显著差异。从根本上讲，鼻咽癌的治疗完全由疾病分期指导。幸运的是，早期疾病患者单纯接受放射治疗（RT），尤其是在调强放射治疗（IMRT）出现后，其生存结果令人鼓舞。报道的五年局部控制率非常出色，范围在70%至90%之间。不幸的是，尽管对中期（II期）和晚期（III-IVB期）鼻咽癌患者进行了严格的根治性治疗，但仍有大约三分之一（30%）的患者出现局部区域或远处复发。目前，复发和转移性鼻咽癌的治疗在很大程度上令人沮丧，给治疗医生带来了重大挑战。广义上讲，复发和转移性鼻咽癌的治疗有三种方案，即：（i）姑息性全身化疗，（ii）分子靶向治疗，和（iii）免疫治疗。本研究的目的是全面回顾现有关于分子靶向治疗在复发和转移性鼻咽癌患者治疗中的效用和安全性的文献，特别关注血管内皮生长因子（VEGF）和表皮生长因子受体（EGFR）靶点。
