局部晚期鼻咽癌放射治疗的研究进展

Progress in the treatment of local advanced nasopharyngeal carcinoma

目的:分析局部晚期鼻咽癌治疗的国内外研究现状和进展,为临床治疗提供依据。方法:应用PubMed和CNKI等数据检索系统及数据库,以"鼻咽肿瘤和放射治疗"等为关键词检索2000-01-2010-06的相关文献,纳入标准:1)鼻咽癌治疗的临床试验,包括方法、结果和进展;2)鼻咽癌放疗、化疗及其他治疗的疗效及不良反应。根据纳入标准符合分析的文献27篇。结果:各种治疗方法的临床研究均取得了一定的进展,其中调强放疗的应用使局部晚期鼻咽癌的局部控制率>90%,且使得放疗的急慢性不良反应较常规放疗明显减轻,但同时也对靶区的确定和勾画提出了更为严格的要求。联合化疗在提高总生存率及降低远处转移率方面是有意义的,其中同步放化疗的疗效最为显著。靶向药物的应用为鼻咽癌的治疗提供了新的方向,是目前研究的热点,但需要进一步的临床试验。结论:局部晚期鼻咽癌在治疗上仍以放射治疗为主,联合同步化疗或与靶向药物结合都取得了较为有效的作用。

OBJECTIVE：To summarized the recent progress in the treatment of local advanced nasopharyngeal carcinoma.METHODS：The PubMed system and CNKI databases were searched using the keywords nasopharyngeal carcinoma and therapy,published from Jan.2000 to Jun.2010.Criteria of paper adoption： 1） Clinical study of nasopharyngeal carcinoma including the methods,result,and progresses;2） Analysis the efficacy,side effects of radiotherapy,chemotherapy and other therapies.According to the above criteria,27 papers were finally selected for analyzed and reviewed.RESULTS： All of these different therapies make some improvement.And most of researches focus on the intensity modulated radiation therapy（IMRT）,IMRT brings local control rates up to more than 90% and obviously decreases the side effects compared with the conventional radiotherapy with better sparing of the surrounded normal tissue,while IMRT need more strictly request for the target coutoured.Combine chemotherapy with radiotherapy can reduce the metastasis rate and improve the overall survival（OS）,and concurrent chemo-radiotherapy is the most promising strategy to cope with the disease.Target therapy has become an important new treatment option;however,there need further clinical research to confirm their effect.CONCLUSION：At present radiotherapy is still the main method in the treatment of loco-regionally advanced nasopharyngeal carcinoma,combined with concurrent chemotherapy or target therapy also have shown great effect.