Characteristic And Novel Therapeutic Strategies Of Nasopharyngeal Carcinoma With Synchronous Metastasis

• Main Authors: Liao W, Tian M, Chen N
• Format: Article
• Language: English
• Published: Dove Medical Press 2019-09-01
• Series: Cancer Management and Research
• Subjects: Nasopharyngeal carcinoma; radiotherapy; chemotherapy; immunotherapy; metachronous
• Online Access: https://www.dovepress.com/characteristic-and-novel-therapeutic-strategies-of-nasopharyngeal-carc-peer-reviewed-article-CMAR
• ISSN: 1179-1322

Wenjun Liao, Maolang Tian, Nianyong Chen Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu, People’s Republic of ChinaCorrespondence: Nianyong ChenDepartment of Radiation Oncology, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of ChinaTel [phone]Fax [phone]Email [e-mail]: Nasopharyngeal carcinoma (NPC) is rare in Western countries, but its incidence in China and Southeast Asia is notably high. NPC shows a high rate of distant metastasis including metachronous metastasis (mmNPC, metastasis after definitive chemo-radiotherapy) and synchronous metastasis (smNPC, metastasis at initial diagnosis). 4–10% of patients would be diagnosed as smNPC annually, and the survival outcomes of these patients are quite poor. As with few clinical trials exclusively focusing on this population, treatment on smNPC is not unified and many problems remain unsolved. To date, systematic chemotherapy (CT) still remains a fundamental treatment in smNPC. Although no randomized trial has been conducted to compare different CT regimens in smNPC, gemcitabine and taxanes in combination with platinum seem optimal in first-line setting. In second-line CT, there is no consensus: mono-chemotherapy with drugs such as gemcitabine, taxanes or capecitabine could be taken into consideration. Immunotherapy based on checkpoint inhibitors shows promising efficacy both in first-line and in the following lines of therapy. In addition to CT, local therapy in smNPC is also very important. Locoregional radiotherapy (RT) for primary tumor in combination with CT could strikingly increase OS with acceptable toxicities. And local treatment, such as surgery and RT, for metastatic lesions could bring extra survival benefit in patients with solitary or limited metastases. Overall, the present study provides an overview of the literature on the various studies of smNPC.Keywords: nasopharyngeal carcinoma, radiotherapy, chemotherapy, immunotherapy, metachronous