Induction chemotherapy combined with concurrent chemoradiotherapy for nasopharyngeal carcinoma

Radiotherapy is the first choice for the treatment of NPC. Patients with recurrence after radiotherapy or residual primary cancer lesions need adjuvant chemotherapy. If adjuvant chemotherapy is used after radiotherapy, the efficacy of adjuvant chemotherapy may be reduced due to vascular occlusion in the tumor bed after radiotherapy, mucositis during radiotherapy, and deterioration of the patient's physical condition. If simultaneous radiotherapy and chemotherapy are used, the coordination and synergistic effect of radiotherapy and chemotherapy is very limited, and it cannot reduce the distant metastasis rate after treatment of NPC.

Induction chemotherapy combined with concurrent chemoradiotherapy can achieve a relatively satisfactory therapeutic effect in the treatment of nasopharyngeal carcinoma. The advantages of induction chemotherapy are: ① There is no vascular occlusion and fibrosis caused by radiotherapy, and the tumor has a good blood supply, which is conducive to the distribution and effect of chemotherapy drugs in local lesions; ② The nutritional status of patients before radiotherapy is good, and they are sensitive to chemotherapy and have good tolerance; ③ It can reduce the tumor burden and relieve various clinical symptoms caused by the tumor in a short period of time, which increases the sensitivity of the tumor to subsequent radiotherapy and enhances the patient's confidence in the cure of the disease; ④ Kill subclinical metastatic lesions throughout the body as soon as possible; ⑤ Tumor regression can simplify the subsequent radiotherapy plan design and dose calculation.

Clinical studies have shown that induction chemotherapy combined with concurrent chemoradiotherapy is feasible in the treatment of nasopharyngeal carcinoma, and the treatment compliance can reach almost 100%.