Enhancing Efficacy and Reducing Toxicity: Therapeutic Optimization in Locoregionally Advanced Nasopharyngeal Carcinoma
JIANG Wei, LÜ Jiawei, TANG Linglong, SUN Ying, CHEN Yupei*, MA Jun*
IMRT (intensity-modulated radiation therapy) has emerged as the fundamental treatment modality for NPC (nasopharyngeal carcinoma), significantly improving local control rates and patient survival. However, distant metastasis remains the primary cause of treatment failure. Recent large-scale clinical trials have demonstrated that combining systemic chemotherapy with IMRT can enhance survival rates in high-risk patients with locoregionally advanced NPC. Notably, induction chemotherapy and metronomic adjuvant chemotherapy, due to their significant efficacy and favorable patient tolerance, have become the preferred treatment regimens recommended in international guidelines. Moreover, as survival extends, maintaining patients’ quality of life becomes increasingly important. Recent advancements in toxicity reduction strategies for NPC has shown enhanced patients’ quality of life while preserving treatment efficacy. These strategies include chemotherapy exemptions, the adoption of lowtoxicity, equivalent chemotherapy agents, and the exemption of low-risk lymph node regions from prophylactic irradiation. Furthermore, immunotherapy has emerged as a research hotspot in the treatment of locoregionally advanced NPC, demonstrating its ability to enhance treatment outcomes. Further research is needed to determine the optimal timing and regimen for its integration with chemoradiotherapy.
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