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诱导化疗在鼻咽癌中的应用

2018年11月17日

编译：肿瘤资讯

来源：肿瘤资讯

诱导化疗在鼻咽癌中的应用

Robert Haddad

教授

哈佛大学医学院头颈肿瘤中心主任
NCCN委员会头颈肿瘤组常务委员
NCCN委员会甲状腺癌组组长

Robert Haddad教授在头颈肿瘤诱导化疗放疗做了诸多研究。本次研讨会，他向我们介绍了目前在鼻咽癌中，诱导化疗的进展与应用。鼻咽癌是对化疗非常敏感的瘤种。既往研究表明，化疗能够降低鼻咽癌病人远处转移的风险。然而，最适宜的化疗时机和方案仍有争议。一项来自中山大学肿瘤防治中心的随机对照临床研究表明，在同期放化疗后增加辅助化疗，并不能够提高患者生存。而在他们另外一项研究中，在同期放化疗前增加三程诱导化疗，可使得病人获得明显生存获益。由他们主持的一项纳入四项随机对照临床研究个体数据的合并分析亦支持诱导化疗在鼻咽癌中的地位。基于以上研究，目前NCCN指南将诱导化疗+同期放化疗作为2B类证据对晚期鼻咽癌患者推荐。期待未来能够有更多关于诱导化疗的研究，例如分享各中心诱导化疗的经验，如何筛选诱导化疗获益人群等等。

The role of induction chemotherapy in nasopharyngeal carcinoma

Pro. Robert Haddad did a lot of work in the use of induction chemotherapy in head and neck cancer. In this symposium, he mainly introduced several studies investigating the role of induction chemotherapy in nasopharyngeal carcinoma. NPC is a chemotherapy sensitive cancer. Previous studies demonstrated that chemotherapy could lower the risk of distant metastasis in NPC, however, confusion still exist regarding its optimal timing and regimen. Jun Ma et al reported that adding three cycles of PF adjuvant chemotherapy to concurrent chemoradiotherapy could not improve survival. Conversely, in their another trial which added three cycles of TPF induction chemotherapy before concurrent chemoradiotherapy, survival rates were significantly higher in patients received induction chemotherapy. A pooled analysis which analyzed individual patient data of four randomized trials also supports the use of induction chemotherapy for advanced NPC. Currently, based on the studies described above, induction chemotherapy followed by concurrent chemoradiotherapy was recommended as evidence category 2B for NPC in the newest version of NCCN guideline. More studies are warranted in the future, such as the experiences and patient data from different centres, the role of EBV in patient selection for induction chemotherapy, and so on.