老年鼻咽癌临床特点及治疗的研究进展  

Clinical characteristics and treatment progress in the elderly patients with nasopharyngeal carcinoma

作　　者：高敏洁 周俊东[1] 薛景[1] GAO Minjie;ZHOU Jundong;XUE Jing(Department of Radiation Oncology,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou 215000,Jiangsu Province,China)

机构地区：[1]南京医科大学附属苏州医院肿瘤放疗科,江苏苏州215000

出　　处：《肿瘤》2020年第9期656-664,共9页Tumor

基　　金：苏州市肿瘤临床医学中心项目(编号:SZZX201506)。

摘　　要：鼻咽癌(nasopharyngeal carcinoma,NPC)是东南亚地区常见的头颈部恶性肿瘤,可发生于各个年龄阶段,随着社会的老龄化,老年NPC患者的数量也在不断增加。老年NPC有着自己独特的临床特征,如早诊率低、分期晚和合并疾病多等,这些特点直接影响到老年患者的规范化治疗及长期生存。在调强放射治疗(radiation therapy,RT)的背景下,老年患者能较好的耐受RT,但目前治疗中的主要争议是联合化疗的应用及化疗方案的选择。在选择化疗方案时,临床医生应着重考虑老年NPC患者的合并疾病、复发转移高危因素以及治疗相关的不良反应,从而选择高效低毒的治疗方案。此外,靶向治疗和免疫治疗等在日后也可能应用于NPC的治疗中,其前景值得期待。因此,本文结合老年NPC患者的临床特点对其治疗策略作一综述,以期为老年NPC患者制定更优化的治疗方案提供一些新的参考依据。Nasopharyngeal carcinoma(NPC)is a common malignant tumor in head and neck,endemic in Southeast Asia.It can occur at any age.With the world’s population continuing to age,a greater proportion of patients with NPC are elderly.The elderly NPC patients are characterized with low early diagnostic rate,advanced clinical stage and multiple comorbidities,which have a substantial impact on the use of standard chemo-radiotherapy and long-term survival in older patients.With the widespread application of intensity modulated radiation therapy,the elderly NPC patients can tolerate radiotherapy well.However,the main challenge is the application of combined chemotherapy and the choice of chemotherapy regimen.Clinicians should focus on comorbidities,high-risk factors for relapse and metastasis,and treatment-related adverse events in elderly NPC patients,to choose a highly-effective and low-toxicity chemotherapy regimens.In addition,targeted therapies and immunotherapy have become new research directions in the future and the prospect of treatment is worth looking forward to.This article summarizes the clinical characteristics and management of NPC in elderly patients in order to provide a reference for the development of a more optimal treatment regimen.

关 键 词：鼻咽癌 老年医学 放射疗法 药物疗法 靶向治疗 免疫治疗 合并症 

分 类 号：R739.63[医药卫生—肿瘤]