What are the treatment principles and treatment methods for nasopharyngeal carcinoma?

What are the treatment principles for nasopharyngeal carcinoma? What are the treatment methods?

The treatment principles for nasopharyngeal carcinoma are as follows:

Stage I: Radical radiotherapy with external beam radiation or external beam radiation aftertreatment

Phase II: Radical radiotherapy combined with chemotherapy is in the clinical research stage.

Stage III/IVM0: Combined treatment of radiotherapy and chemotherapy, with cisplatin-based synchronous chemoradiotherapy as the main approach. Other chemotherapy regimens and their combination methods are under clinical research; chemoradiotherapy and molecular targeted therapy such as epidermal growth factor are under clinical research.

M1 stage: Chemotherapy is the main treatment.

For large cervical lymph nodes, heat therapy can be given at the same time.

After radical radiotherapy, residual lymph nodes can be observed for 2-3 months. If there is no change or progression in the residual lesions, sectional neck dissection or residual lymph node enucleation can be considered.

In terms of treatment methods, since most of the pathological examinations are poorly differentiated squamous cell carcinomas, the recognized first-choice treatment method is radiotherapy. Conventional radiotherapy has many complications, and three-dimensional conformal or intensity-modulated radiotherapy is recommended. The total irradiation dose to the nasopharynx is 66-70Gy/6.5-7 weeks, the radical dose for those with positive cervical lymph nodes is 56-60Gy, and the preventive irradiation dose for those with negative cervical lymph nodes is 46-50Gy. During radiotherapy, chemotherapy, traditional Chinese medicine and immunotherapy can be combined to improve the efficacy. For some patients with advanced disease and recurrence after radiotherapy, as well as a few adenocarcinomas that are less sensitive to radiation and well-differentiated squamous cell carcinomas, comprehensive treatment methods such as chemotherapy and surgery can be used.