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Progress in the comprehensive treatment of nasopharyngeal carcinoma:a review for risk-stratified management strategies

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Holistic Integrative Oncology 2023年第1期2卷 173-181页

作者： Yang Liu Ziou Du Shiyu Song Junlin Yi Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College17 Panjiayuan NanliChaoyang DistrictBeijing 100021P.R.China Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer HospitalChinese Academy of Medical Sciences(CAMS)Tongxi RoadGuangyang DistrictLangfangHebei Province 065001P.R.China Department of Radiation Oncology Virginia Commonwealth University Health System1001 E.Leigh StreetBox 980058RichmondVA 23219USA

Purpose A“one-size-fits-all”treatment recommendation is not advisable for nasopharyngeal carcinoma(NPC).This article aims to review the risk-stratified strategies and propose future directions in *** For low-risk NPC patients,a review of literature shows that de-escalation approaches can be generally categorized into de-escalating systemic therapy and de-escalating *** have explored the exemption of concurrent chemotherapy in stage II and T3N0M0 NPC patients,as well as sparing concurrent chemotherapy after induction chemotherapy in selected low-risk patients,changing the cisplatin-based chemotherapy schedules,and ***-escalation of radiotherapy involves a reduction in dose and clinical treatment volume(CTV).For high-risk patients,increasing treatment intensity is commonly used,including selecting appropriate patients to receive induction or adjuvant chemotherapy or adding targeted therapy to standard chemo-radiotherapy to improve *** many instances,these risk-stratified approaches are guided by the measurement of Epstein-Barr virus DNA levels and various image-based *** has shown initial efficacy in recurrent or metastatic NPC *** treatment advances of ICIs monotherapy in Locoregionally advanced NPC have remained scarce,and several phase II and III anti-PD-1/PD-L1 monoclonal antibody clinical trials are currently *** Various strategies for the risk-stratified treatment of NPC have been investigated and remain highly effective in most *** of patient selection is still critical,and both long-term oncological outcomes and late complications remain to be *** prospective,multi-institutional researches are needed to elucidate how best to individualize the treatment of NPC.

关键词： Nasopharyngeal carcinoma Progress Comprehensive treatment risk-stratified strategies Future directions

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