Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
Department Radiation Oncology, GenesisCare St Vincent's Hospital, Melbourne, Australia.
Cancer Treat Rev. 2020 Apr;85:101995. doi: 10.1016/j.ctrv.2020.101995. Epub 2020 Feb 21.
Up to one in four patients with nasopharyngeal carcinoma present with non-metastatic stage IV disease (i.e. T4 or N3). Distinct failure patterns exist, despite the routine adoption of contemporary treatment modalities such as intensity modulated radiotherapy and systemic chemotherapy. Concurrent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy or induction chemotherapy followed by CCRT are commonly employed in this setting, with the latter emerging as the preferred option. Additionally, emerging radiation technologies like proton therapy has become available offering new opportunities for prevention of radiation-induced side effects. This article reviews not only the current treatment strategies, but also discusses novel ways to tackle this challenging disease with respect to the patterns of failure.
约四分之一的鼻咽癌患者就诊时已处于局部晚期 IV 期（即 T4 或 N3）。尽管采用了调强放疗和全身化疗等现代治疗方法，但仍存在明显的失败模式。在这种情况下，通常采用同步放化疗（CCRT）后辅助化疗或诱导化疗后 CCRT，后者已成为首选。此外，新兴的放射治疗技术如质子治疗也已应用于临床，为预防放射性副作用提供了新的机会。本文不仅回顾了当前的治疗策略，还讨论了针对失败模式的新方法来应对这一具有挑战性的疾病。
