局部晚期鼻咽癌新辅助化疗研究进展

Research Progress of Neoadjuvant Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma

鼻咽癌的治疗手段是以放射治疗为主的综合治疗,随着调强放疗等精确放疗技术和放化综合治疗的广泛应用,初治鼻咽的局部控制率已经提高到90%以上。为了提高局部晚期鼻咽癌的治愈率、降低复发或远处转移,放疗与化疗的结合一直是学者们研究热点。由于同步放化疗已成为局部晚期鼻咽的标准治疗,新辅助化疗是鼻咽癌综合治疗研究的热点,新辅助联合同步放化疗是否获益一直存在争议。同时调强放疗的大量应用,同步化疗的地位受到怀疑,新辅助化疗在调强时代能否替代同步化疗及新辅助化疗后靶区应如何勾画值得进一步研究。因此,本文就新辅助化疗治疗局部晚期鼻咽癌的进展进行综述。

The main treatment method for nasopharyngeal carcinoma is radiotherapy. With the wide applications of intensity-modulated radiation therapy（IMRT） and other accurate radiotherapy technology and integrated treatment, the local control rate of nasopharyngeal carcinoma has been improved to 90%. In order to improve the cure rate and reduce the recurrence or distant metastasis, the combination of radiotherapy and chemotherapy has been a hot spot. As concurrent chemotherapy has become the standard treatment for locally advanced nasopharyngeal carcinoma, neoadjuvant chemotherapy is a hot spot in the research of comprehensive treatment of nasopharyngeal carcinoma, and whether patients would be benefit from neoadjuvant combined with concurrent chemoradiotherapy has been a controversial issue. At the same time, due to the wide applications of IMRT, the status of concurrent chemotherapy is suspected. Whether the neoadjuvant chemotherapy could replace the concurrent chemotherapy and how to delineate the target area after neoadjuvant chemotherapy are worth further study in the era of IMRT. Therefore, this article reviews the progress of neoadjuvant chemotherapy in the treatment for locally advanced nasopharyngeal carcinoma.