儿童鼻咽癌的治疗进展

Progress on treatment for childhood nasopharyngeal carcinoma

鼻咽癌在儿童疾病中较罕见,在儿童恶性肿瘤中发病率<5%,遗传易感性可能是儿童鼻咽癌发病特性。放化疗综合治疗是局部晚期鼻咽癌的主要治疗模式,调强放疗是目前儿童鼻咽癌首选放疗方式。化疗同样选择铂类为基础的诱导化疗、同步化疗或辅助化疗。84%的鼻咽癌患儿放疗后产生不同程度的放射性损伤,目前仍缺乏最佳放疗剂量、化疗和放化疗联合方案,以期减少并发症,改善远期生存质量。此外,新型靶向治疗、免疫治疗等是未来研究方向,对儿童鼻咽癌治疗需要前瞻性多中心试验进一步探讨。本文就目前儿童鼻咽癌的临床科研成果和未来研究方向进行论述。

Nasopharyngeal carcinoma is a rare condition, accounting for 5% of all malignant tumors in children, and genetic susceptibility may be its pathogenesis. Chemoradiotherapy is the main treatment modality for locoregional advanced nasopharyngeal carcinoma. Intensity-modulated radiotherapy with platinum-based induction chemotherapy, synchronous chemotherapy, or adjuvant chemotherapy is the preferred treatment for childhood nasopharyngeal carcinoma. After radiotherapy, 84% of patients with childhood nasopharyngeal carcinoma have different degrees of radiation injury. For now, there is still a lack of the best combination regimen of radiation dose, chemotherapy, and chemoradiotherapy to reduce complications and improve the long-term quality of life. In addition, future studies should focus on the new type of targeted immunotherapy for childhood nasopharyngeal carcinoma; moreover, further prospective multicenter trials should be conducted. This review illustrates the clinical research achievements and future research directions for childhood nasopharyngeal carcinoma.