Department of Otolaryngology, Head and Neck Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
Curr Oncol Rep. 2020 Jul 9;22(9):86. doi: 10.1007/s11912-020-00949-0.
Treatment failure, in the form of either persistence or local recurrence, occurs in 10 to 30% of nasopharyngeal carcinoma patients after initial radiotherapy (RT). Early detection of persistent or recurrent disease aids in the recognition of tumors that can be candidates for salvage nasophayngectomy or re-irradiation. There is no consensus till now on the indications or selection of the above two salvage treatment.
In recent years, there has been a paradigm shift from open to endoscopic approach for nasopharyngectomy, which carries nearly no complications. For salvage re-irradiation, intensity-modulated radiotherapy (IMRT) is the most commonly indicated modality. Compared to IMRT, salvage endoscopic nasopharyngectomy may be more beneficial in terms of prolonging survival, improving quality of life, and minimizing treatment-related complications and medical costs in a selected subset of recurrent nasopharyngeal carcinoma (rNPC) patients. Salvage nasopharyngectomy should be the mainstay of treatment for rNPC.
初始放疗（RT）后，10%至 30%的鼻咽癌患者会出现治疗失败，表现为持续性或局部复发。早期发现持续性或复发性疾病有助于识别可进行挽救性咽旁切除术或再放疗的肿瘤。目前，对于这两种挽救性治疗的适应证或选择尚没有共识。
近年来，咽旁切除术已从开放式手术向内镜手术转变，内镜手术几乎没有并发症。对于挽救性再放疗，调强放疗（IMRT）是最常用的方式。与 IMRT 相比，挽救性内镜咽旁切除术在延长生存时间、提高生活质量以及最大限度地减少治疗相关并发症和医疗费用方面可能对选择的复发性鼻咽癌（rNPC）患者更有益。挽救性咽旁切除术应成为 rNPC 的主要治疗方法。
