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Nasopharyngeal carcinoma.

¹State Key Laboratory in Oncology in South China, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute, The Chinese University of Hong Kong. anthony@clo.cuhk.edu.hk

Annals of Oncology : Official Journal of the European Society for Medical Oncology

|October 15, 2010

Summary

Distant metastases are the main failure for nasopharyngeal carcinoma despite improved radiotherapy. Current treatments include cisplatin-radiotherapy, with neoadjuvant chemotherapy showing promise. Epstein-Barr virus (EBV) DNA monitoring is valuable for patient management.

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Area of Science:

Oncology
Radiotherapy
Medical Virology

Background:

Nasopharyngeal carcinoma (NPC) management has evolved with advanced imaging and radiotherapy, improving local control.
Distant metastasis has emerged as the primary cause of treatment failure in NPC patients.
Current standard treatment for Stage IIB and above NPC involves concurrent cisplatin-radiotherapy, potentially with adjuvant chemotherapy.

Purpose of the Study:

To review the current treatment strategies for nasopharyngeal carcinoma.
To highlight the evolving role of neoadjuvant chemotherapy and novel therapeutic approaches.
To discuss the clinical utility of quantitative Epstein-Barr virus (EBV) DNA in NPC management.

Main Methods:

Review of current literature on nasopharyngeal carcinoma treatment and management.
Analysis of standard treatment protocols, including concurrent chemoradiotherapy and adjuvant chemotherapy.
Evaluation of emerging therapies such as neoadjuvant chemotherapy, targeted agents, and immunotherapy.

Main Results:

Improved local control in NPC has shifted the focus to managing distant metastases.
Neoadjuvant chemotherapy is a promising strategy, with phase III trial results pending.
Quantitative Epstein-Barr virus (EBV) DNA shows clinical utility for disease monitoring and potential risk stratification.

Conclusions:

Nasopharyngeal carcinoma treatment is increasingly focused on preventing distant metastases.
Neoadjuvant chemotherapy and novel targeted/immunotherapies represent future directions in NPC treatment.
Quantitative EBV DNA monitoring offers valuable insights for patient follow-up and personalized treatment strategies.