同期放化疗后时代的鼻咽癌新辅助化疗

Nasopharyngeal carcinoma neoadjuvant chemotherapy among the concurrent chemoradiation era

局部晚期鼻咽癌的治疗以综合治疗为主,同期放化疗已成为公认的治疗方式。鼻咽癌的新辅助化疗虽然对提高总生存方面的作用尚不肯定,但是其优良的缓解率及减少远处转移的潜能,仍可使部分患者受益。含新的化疗药物(如紫杉醇)的新辅助化疗方案已取得较好的临床疗效,使得新辅助化疗再次获得关注。新辅助化疗联合后续的同期放化疗对比同期放化疗的临床课题正广泛地开展。预测新辅助化疗的疗效,优化与后续放疗的配合正成为共同关注的热点。

The concurrent chemoradiation therapy was defined as the standard treatment strategy for patients with locoregionally advanced nasopharyngeal carcinoma（NPC）.Neoadjuvant chemotherapy can increase the response rate and has the potential to reduce distant metastases in the patients with advanced nasopharyngeal carcinoma;however it failed to gain the survival benefit.The addition of paclitaxel and cisplatin-based neoadjuvant chemotherapy has showed promising efficacy and safety in the phase Ⅰ/Ⅱ studies,the comparing of neoadjuvant chemotherapy followed by concurrent chemoradiation versus concurrent chemoradiation has been wildly studied in a phase Ⅲ trial.To find the response prediction index of neoadjuvant chemotherapy and to modify the sequenced chemoradiation have been the hot spot of research.We wish it would provide evidence for selection of this treatment modality for clinic.