How to choose a treatment plan for nasopharyngeal carcinoma

  Nasopharyngeal carcinoma is a characteristic tumor in China, and its main incidence area is in China, especially in the southern Guangdong region, where it is most common, hence the common name “Guangdong tumor”. Due to the advancement of radiotherapy technology, about 80% of patients with nasopharyngeal cancer can now be clinically cured. Therefore, reasonable and standardized treatment is especially important for nasopharyngeal carcinoma.  The main treatments for nasopharyngeal cancer include radiotherapy, chemotherapy, targeted therapy and surgery, among which radiotherapy is the most important in the radical treatment of nasopharyngeal cancer, chemotherapy and targeted therapy play an auxiliary role, and surgery is used as a supplementary treatment for biopsy and removal of residual lesions.  Radiotherapy is a treatment method that uses radiation to kill tumor cells. Nasopharyngeal cancer now basically adopts intensity-modulated radiation therapy technique, which can ensure the radiation therapy dose to the tumor to the maximum extent while minimizing the irradiation of normal tissues and organs. The number of radiotherapy sessions is usually 30-33, and some patients who have residual lesions at the end of radiotherapy may have 1-3 additional sessions. Radiotherapy is given once a day, five times a week, with two days off on the weekend when patients do not have radiotherapy. Among them, the radio-wave knife technique is mainly for the treatment of lesion residual dosing, recurrence after radiotherapy, and already treated metastatic lesions, compared with the ordinary radiotherapy technique.  Chemotherapy is the use of cytotoxic drugs to kill tumor cells by intravenous infusion. Chemotherapy is further divided into induction chemotherapy, synchronous chemotherapy and adjuvant chemotherapy according to the schedule of radiotherapy. Induction chemotherapy is administered after radiotherapy, synchronous chemotherapy is administered simultaneously with radiotherapy, and adjuvant chemotherapy is administered after radiotherapy. According to available clinical studies, there is clear evidence that synchronous chemotherapy improves the efficacy of treatment.  Targeted therapy is based on the specific therapeutic targets of tumor cells, which can be precisely guided to kill tumor cells. However, these drugs are not reimbursable because of their high cost, and only a small number of patients use them.  The value of surgical treatment is mainly reflected in three aspects, one is in the diagnosis, the vast majority of tumor diagnosis depends on pathological biopsy, so surgery is needed to take tumor tissue for biopsy to clarify the diagnosis. The second is for patients who still have lymph nodes left after treatment and are identified as positive lymph nodes, they can be surgically removed. The third one is for patients with recurrence, some of them can have their nasopharyngeal lesions or lymph nodes removed for salvage treatment.  The treatment of nasopharyngeal carcinoma requires rational arrangement of the above treatments and the formulation of standardized treatment plans according to different stages and phases of patients. In addition, because radiotherapy for nasopharyngeal cancer is relatively complex and technically difficult, it requires high requirements for doctors’ treatment experience and radiotherapy equipment, so patients must choose hospitals with relevant treatment conditions for consultation.