Current management of stage IV nasopharyngeal carcinoma without distant metastasis

Wai Tong Ng; June Corry; Johannes A Langendijk; Anne W M Lee; Antti Mäkitie; William M Mendenhall; Alessandra Rinaldo; Juan P Rodrigo; Nabil F Saba; Robert Smee; Primož Strojan; Carlos Suárez; Jan B Vermorken; Alfio Ferlito

doi:10.1016/j.ctrv.2020.101995

Current management of stage IV nasopharyngeal carcinoma without distant metastasis

Cancer Treat Rev. 2020 Apr:85:101995. doi: 10.1016/j.ctrv.2020.101995. Epub 2020 Feb 21.

Authors

Affiliations

¹ Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
² Department Radiation Oncology, GenesisCare St Vincent's Hospital, Melbourne, Australia.
³ Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
⁴ Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, People's Republic of China.
⁵ Department of Otorhinolaryngology - Head and Neck Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
⁶ Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, United States.
⁷ University of Udine School of Medicine, Udine, Italy.
⁸ Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
⁹ Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia.
¹⁰ Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, NSW, Australia.
¹¹ Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
¹² Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
¹³ Department of Medical Oncology, Antwerp University Hospital, Belgium.
¹⁴ International Head and Neck Scientific Group, Padua, Italy.

PMID: 32113080
DOI: 10.1016/j.ctrv.2020.101995

Abstract

Up to one in four patients with nasopharyngeal carcinoma present with non-metastatic stage IV disease (i.e. T4 or N3). Distinct failure patterns exist, despite the routine adoption of contemporary treatment modalities such as intensity modulated radiotherapy and systemic chemotherapy. Concurrent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy or induction chemotherapy followed by CCRT are commonly employed in this setting, with the latter emerging as the preferred option. Additionally, emerging radiation technologies like proton therapy has become available offering new opportunities for prevention of radiation-induced side effects. This article reviews not only the current treatment strategies, but also discusses novel ways to tackle this challenging disease with respect to the patterns of failure.

Keywords: Chemotherapy; Immunotherapy; Nasopharyngeal carcinoma; Prognosis; Radiotherapy; Targeted therapy.

Publication types

Review

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Biopsy, Needle
Cause of Death*
Chemoradiotherapy / methods
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Immunohistochemistry
Induction Chemotherapy / methods
Male
Nasopharyngeal Carcinoma / diagnostic imaging
Nasopharyngeal Carcinoma / mortality
Nasopharyngeal Carcinoma / pathology*
Nasopharyngeal Carcinoma / therapy*
Nasopharyngeal Neoplasms / diagnostic imaging
Nasopharyngeal Neoplasms / mortality
Nasopharyngeal Neoplasms / pathology*
Nasopharyngeal Neoplasms / therapy*
Neoplasm Invasiveness / pathology
Neoplasm Metastasis
Neoplasm Staging
Positron-Emission Tomography / methods
Prognosis
Risk Assessment
Survival Analysis
Treatment Outcome