调强放疗时代临床Ⅱ期鼻咽癌化疗进展  

Research progress on chemotherapy for clinical stageⅡnasopharyngeal carcinoma in the era of intensity-modulated radiotherapy

作　　者：刘洋 张烨 易俊林 Yang Liu;Ye Zhang;Junlin Yi(Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2022年第8期732-736,共5页Chinese Journal of Radiation Oncology

摘　　要：调强放疗技术的应用显著改善了临床Ⅱ期鼻咽癌患者的预后。尽管美国国家综合癌症网指南推荐临床Ⅱ期鼻咽癌使用同步放化疗策略,但该证据多基于二维放射技术条件下的研究结果,调强放疗技术条件下是否需要联合化疗仍值得探讨。本文综述了临床Ⅱ期鼻咽癌化疗的研究现状,多个研究表明同期、辅助、诱导化疗均未能提高疗效,但明显增加不良反应发生率。由于临床Ⅱ期鼻咽癌存在异质性,部分研究发现高危患者可从化疗中获益。如何区分临床Ⅱ期鼻咽癌中的高危患者是目前研究的热点。转移淋巴结特征以及EB病毒DNA、炎性标记物等因素对筛选高危患者有一定参考价值,有待进一步验证,结合多种肿瘤特征的预测模型似乎能更好发现高危人群,指导高危Ⅱ期鼻咽癌的治疗决策。The prognosis of patients with clinical stageⅡnasopharyngeal carcinoma has been significantly improved by the application of intensity-modulated radiotherapy(IMRT).Although the NCCN guidelines recommend concurrent chemoradiotherapy strategies for clinical stageⅡnasopharyngeal carcinoma,the evidence is mostly based on the research results under the condition of two-dimensional conventional radiotherapy,and whether combined chemotherapy is required under the condition of IMRT faces challenges.In this article,current research progress on chemotherapy for clinical phaseⅡnasopharyngeal carcinoma was reviewed.Several studies have shown that concurrent,adjuvant and induction chemotherapy failed to improve the efficacy but significantly increased the incidence of toxic and side effects.Because of the heterogeneity in clinical stageⅡnasopharyngeal carcinoma,some studies have found that high-risk patients could benefit from chemotherapy.Currently,how to distinguish high-risk patients in clinical stageⅡnasopharyngeal carcinoma is a hot spot.The characteristics of metastatic lymph nodes,EB virus DNA,inflammatory markers,and other factors have certain reference value for screening high-risk patients,which needs further verification.The prediction model integrating multiple tumor characteristics seems to better identify high-risk groups and guide the treatment decision of high-risk stageⅡnasopharyngeal carcinoma.

关 键 词：鼻咽肿瘤 调强放射疗法 化学疗法 研究进展 

分 类 号：R739.63[医药卫生—肿瘤]