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复发性鼻咽癌:包括COVID-19大流行期间建议在内的局部治疗选择的批判性综述

Recurrent Nasopharyngeal Cancer: Critical Review of Local Treatment Options Including Recommendations during the COVID-19 Pandemic.

作者信息

Svajdova Michaela, Sicak Marian, Dubinsky Pavol, Slavik Marek, Slampa Pavel, Kazda Tomas

机构信息

Department of Radiation and Clinical Oncology, Central Military Hospital-Teaching Hospital Ruzomberok, 034 01 Ruzomberok, Slovakia.

Department of Radiation Oncology, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.

出版信息

Cancers (Basel). 2020 Nov 25;12(12):3510. doi: 10.3390/cancers12123510.

Abstract

Recurrent nasopharyngeal carcinoma represents an extremely challenging therapeutic situation. Given the vulnerability of the already pretreated neurological structures surrounding the nasopharynx, any potential salvage retreatment option bears a significant risk of severe complications that result in high treatment-related morbidity, quality of life deterioration, and even mortality. Yet, with careful patient selection, long-term survival may be achieved after local retreatment in a subgroup of patients with local or regional relapse of nasopharyngeal cancer. Early detection of the recurrence represents the key to therapeutic success, and in the case of early stage disease, several curative treatment options can be offered to the patient, albeit with minimal support in prospective clinical data. In this article, an up-to-date review of published evidence on modern surgical and radiation therapy treatment options is summarized, including currently recommended treatment modifications of both therapeutic approaches during the coronavirus disease 2019 pandemic.

摘要

复发性鼻咽癌是一种极具挑战性的治疗情况。鉴于鼻咽周围已接受过治疗的神经结构较为脆弱,任何潜在的挽救性再治疗方案都存在严重并发症的重大风险,这些并发症会导致高治疗相关发病率、生活质量下降,甚至死亡。然而,通过仔细的患者选择,一部分局部或区域复发的鼻咽癌患者在进行局部再治疗后可能实现长期生存。复发的早期检测是治疗成功的关键,对于早期疾病,尽管前瞻性临床数据支持有限,但仍可为患者提供几种根治性治疗方案。本文总结了已发表的关于现代手术和放射治疗方案的证据的最新综述,包括在2019冠状病毒病大流行期间目前推荐的两种治疗方法的治疗调整。

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