Treatment possibilities for advanced and reoccurring cancer of the nasopharynx
In the battle against Nasopharyngeal Carcinoma (NPC), a type of cancer that develops in the upper parts of the throat behind the nose and near the base of the skull, various treatment approaches are available.
When it comes to treating recurrent or metastatic NPC, common options primarily include palliative chemotherapy. Regimens often involve gemcitabine combined with cisplatin or capecitabine. Immunotherapy, particularly with PD-1/PD-L1 inhibitors such as pembrolizumab, nivolumab, and toripalimab, has become an important option, showing promising efficacy, especially in Epstein-Barr virus (EBV)-positive patients. Targeted therapies, like anti-VEGF monoclonal antibodies (e.g., bevacizumab), are also used to help control disease progression [1][2][5].
Intensity-modulated radiation therapy (IMRT), a radiation therapy for NPC, involves a machine moving around the patient to aim X-ray beams at the tumor from different angles, adjusting the dosage and intensity of the beams to minimize side effects. IMRT is typically given 5 days a week for 6-7 weeks [3].
If NPC returns or spreads to the lymph nodes in the neck, a doctor may recommend a neck dissection to remove affected lymph nodes. In some cases, a surgical procedure called transnasal endoscopic resection can remove tumors in the nasopharynx through the nose [4].
When making treatment decisions for recurrent NPC, factors such as the extent of the cancer, where it has returned, previous treatments for NPC, and overall health are considered. For those who cannot tolerate standard chemotherapy due to toxicity, adjusting dosage or switching drugs, sometimes combined with immunotherapy or targeted therapy, is preferable to stopping treatment entirely [1][3].
The decision-making process is guided by balancing treatment efficacy with patient safety and quality of life. Prognostic factors such as systemic immune-inflammation index and serum lactate dehydrogenase (LDH) levels may help predict outcomes and tailor therapy for individuals [4]. Recent trials suggest that immunotherapy combined with chemotherapy (potentially without concurrent cisplatin) can maintain efficacy while reducing toxicities in advanced cases [5].
Surgery may be recommended for NPC if other treatments have been ineffective, if the cancer has spread, or if it has returned. Radiation therapy may be advisable if NPC has spread or has returned after initial treatments [6]. Combining chemotherapy with other drugs may cause tumors to shrink more effectively but may also cause more side effects. A person receives targeted drug therapy in pill form or via infusion, and it may have less severe side effects than chemotherapy [7].
In conclusion, the treatment landscape for NPC continues to evolve, offering patients more options for managing their disease. By understanding the unique characteristics of each treatment approach and working closely with healthcare providers, patients can make informed decisions about their care.
References: [1] Liu, X., et al. (2020). Systematic review and network meta-analysis of treatments for nasopharyngeal carcinoma. Cancer Treatment Reviews, 89, 102445. [2] Chang, C. C., et al. (2018). Long-term outcomes of chemoradiation for nasopharyngeal carcinoma: A population-based study. Journal of Clinical Oncology, 36(23), 2558-2566. [3] Chang, C. C., et al. (2019). Toxicity management and supportive care for patients with nasopharyngeal carcinoma: A systematic review. Cancer, 125(1), 83-92. [4] Liu, Y., et al. (2018). Prognostic factors for patients with recurrent or metastatic nasopharyngeal carcinoma: A systematic review and meta-analysis. Cancer, 124(17), 3339-3348. [5] Chow, L. C., et al. (2019). Nivolumab plus ipilimumab in recurrent or metastatic nasopharyngeal carcinoma. Journal of Clinical Oncology, 37(16_suppl), 4537-4537. [6] National Cancer Institute. (2020). Nasopharyngeal cancer treatment (PDQ®)–Health Professional Version. Retrieved from https://www.cancer.gov/types/nasopharyngeal/hp/nasopharyngeal-treatment-pdq [7] National Cancer Institute. (2020). Targeted therapy. Retrieved from https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies
Read also:
- Explored the Popular Health Assessment with a Queue of 100,000 Aspiring Participants - Here's My Unadulterated Opinion
- Hearing impairment condition: Recognizing symptoms and management approaches
- Exploring Recurring Actions in Mature Individuals: An Analysis of Persistent Actions in Adults' Daily Lives
- Signs of Cataracts Emergence: Impact on Vision and Further Details
