Nasopharyngeal carcinoma (NPC) is one of the most common malignant tumor in China, Southeast Asia and North Africa region. The main treatment of NPC is radiation therapy, and concurrent chemoradiotherapy has become the standard treatment for locally advanced NPC Up to date, the targeted therapy in NPC has been gradually appreciated recently, in this paper, NPC biological targeted therapy in recent years as a progress of treatment were reviewed.
Biological Therapy ; Carcinoma ; Chemoradiotherapy ; China ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; therapy ; Radiotherapy

Chemotherapy is one of main treatments for nasopharyngeal carcinoma (NPC) except radiation therapy. Improving and optimizing chemotherapeutic regimen are helpful to improve the therapeutic effects and reduce side effects. At present, concurrent chemoradiotherapy still is the standard treatment for advanced nasopharyngeal carcinoma. Induced chemotherapy has been shown superiority, but the effect of adjuvant chemotherapy needs further study. This paper analyzed the superior and inferior, effect and side effect of all kinds of chemotherapeutic methods or scheme including induced chemotherapy, concurrent chemotherapy, adjuvant chemotherapy and palliative chemotherapy and introduced simply the mechanism and clinical effect of new drugs of anticancer. It was hoped to offer some reference for the selection of chemotherapy for NPC.
Antineoplastic Combined Chemotherapy Protocols ; Carcinoma ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy

Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms/pathology* ; Carcinoma/surgery* ; Neoplasm Recurrence, Local/therapy* ; Treatment Outcome

Carcinoma ; Combined Modality Therapy ; Humans ; Nasopharyngeal Neoplasms ; radiotherapy ; therapy

China/epidemiology* ; Humans ; Nasopharyngeal Carcinoma/therapy* ; Nasopharyngeal Neoplasms/therapy* ; Quality Control

BACKGROUND: The mortality rate among patients with nasopharyngeal carcinoma (NPC) has improved significantly with the advent of chemoradiotherapy strategies. However, distant metastasis remains problematic. Tumor-specific reactivity in cancer patients has been detected exclusively in CD39+ T cells, particularly in CD39+CD103+ T cells. Circulating cancer-specific T cells are important for protecting against metastasis. This study aimed to evaluate the predictive value of circulating CD39+CD8+ T cells for metastasis in patients with NPC. METHODS: We performed a cross-sectional, longitudinal study of 55 patients with newly diagnosed NPC of stage III-IVa. All patients were initially treated with standard combined chemoradiotherapy. Blood samples were obtained from 24 patients before and at 1 month and 6 months after treatment. T cell expression of CD39 and CD103, together with the markers of T cell exhaustion programmed death-1 (PD-1)/T cell immunoglobulin and mucin domain-containing protein 3 (Tim-3) and markers of cell differentiation CD27/CC-chemokine receptor 7/CD45RA, was examined by flow cytometry. The Wilcoxon rank-sum test analysis was used to analyze the differences between two groups. Kaplan-Meier analysis was used for analysis of progression-free survival (PFS). RESULTS: The expression of circulating CD39+CD8+ and CD39+CD103+ CD8+ T cells was significantly higher in patients without distant metastasis (CD39+CD8+: 6.52% [1.24%, 12.58%] vs. 2.41% [0.58%, 5.31%], Z=-2.073, P=0.038 and CD39+CD103+CD8+: 0.72% [0.26%, 2.05%] vs. 0.26% [0.12%, 0.64%], Z=-2.313, P = 0.021). Most CD39+ T cells did not express PD-1 or Tim-3. Patients with high expression of CD39+CD103+CD8+ T cells had better PFS than patients with low expression (log rank value = 4.854, P = 0.028). CD39+CD8+ T cells were significantly elevated at 1-month post-treatment (10.02% [0.98%, 17.42%] vs. 5.91% [0.61%, 10.23%], Z = -2.943, P = 0.003). The percentage of advanced differentiated CD8+ T cells also increased at 1-month post-treatment compared with pre-treatment (33.10% [21.60%, 43.05%] vs. 21.00% [11.65%, 43.00%], Z = -2.155, P = 0.031). There was a significant correlation between elevated CD39+CD8+ T cells and increased effector memory T cells (intermediate stage: r = 0.469, P = 0.031; advanced stage: r = 0.508, P = 0.019). CONCLUSIONS CD39+CD8+ circulating T cells have preserved effector function, contributing to an improved prognosis and a reduced risk of metastasis among NPC patients. These cells may thus be a useful predictive marker for a better prognosis in patients with NPC.
CD8-Positive T-Lymphocytes ; Chemoradiotherapy ; Cross-Sectional Studies ; Humans ; Longitudinal Studies ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms/therapy* ; Prognosis

Nasopharyngeal cancer is a low differentiated squamous cell carcinoma, and the radiation therapy is the primary choice. It's 5 year survival rate may reach 64.4%, while 10.0% cases may suffer from the local recurrence. The salvage radiation or surgery is still the main choice for recurrent cases now. However the recurrent tumor become radiation insensitive and meanwhile, morbidity and mortality become higher. The experience of open salvage surgery on the recurrent radiation insensitive tumor had been proved safely, and the related morbidity and mortality are acceptable. Recently, the endoscopic salvage surgery has been developed, some preliminary experience has been obtained and the result looks promising. In this article, the pathobiological characteristics of the postradiation local recurrent nasopharyngeal cancer, the anatomy of nasopharyngus and related skull base area, especially the petroclival region and current situation of endonasal endoscopic salvage surgery were reviewed here. Basic principle of oncological surgery that endoscopic surgery should followed and possible endoscopic surgical approaches were proposed.
Carcinoma ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; Endoscopy ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Neoplasm Recurrence, Local ; radiotherapy ; surgery ; Radiation Tolerance ; Salvage Therapy ; methods ; Skull Base ; Survival Rate

OBJECTIVE: To analyze the nutritional status and nosocomial infection of nasopharyngeal carcinoma patients before and after the chemoradiotherapy treatment. METHOD: An analysis was made for the nutritional and nosocomial infection status of 82 cases before and after chemoradiotherapy treatment. RESULT: Statistically significant differences were revealed between indexes related with nutritional status such as body mass, hemoglobin, serum albumin before and after the treatment. Sixty-three patients occurred nosocomial infection. The infection rate was 76.83%. The main risk factor was oropharynx mucosal lesion and the rate is 92.68%. Isolates of 39 bacteria were found, of which Gram-negative organisms were 58.97%, Fungi were 30.77%, Gram-positive ones were 7.69%, Herpes zoster were 2.56%. CONCLUSION Chemoradiotherapy has negative influence on nutritional status of patients. Medical personnel should pay attention to patients' nutritional status and do a good job of nutritional status monitoring, nutrition support, dieting guidance, reducing side effects, in order to improve the patient's tolerability and quality of life. The nosocomial infection rate of Gram-negative bacteria of oropharyngeal mucosal is the highest in patients with advanced nasopharyngeal cancer during chemoradiotherapy. It is very important for us to prevent and control nosocomial infection.
Adult ; Aged ; Carcinoma ; Combined Modality Therapy ; Cross Infection ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; microbiology ; radiotherapy ; Nutritional Status ; Risk Factors

OBJECTIVE: To study the effect of low-dose erythromycin combined with sinus displacement therapy on treating sinusitis in patients with nasopharyngeal carcinoma after radiotherapy. METHOD: The sinus displacement were used with mixed liquid of metronidazole, protease and dexamethasone, and meantime roxithromycin was orally administered. RESULT: Effective rate was 97.1% in 35 nasopharyngeal carcinoma patients with sinusitis after radiotherapy. CONCLUSION Low-dose erythromycin combined with sinus displacement therapy is effective to treat sinusitis in patients with nasopharyngeal carcinoma after radiotherapy. Its advantages are safe, effective, and easy to do.
Adult ; Aged ; Carcinoma ; Combined Modality Therapy ; Erythromycin ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; complications ; radiotherapy ; Sinusitis ; complications ; therapy

OBJECTIVE: To observe the effect of nasal endoscope negative pressure cleaning and sinupret drops to treat radiation nasosinusitis (RNS). METHOD: One hundred and fifty-three patients with nasopharyngeal carcinoma were randomly divided into treatment group A, B, C . Group A using nasal endoscope negative pressure cleaning and sinupret drops, group B using nasal endoscope negative pressure cleaning and normal saline spray washing, group C using saline nasal irrigation through nasal catheter. All patients with sinusitis condition were evaluated at the end of radiotherapy, three months and six months after radiotherapy. RESULT: Comparison between groups, three periods of RNS incidence, moderate to severe RNS incidence are A < B < C. Six months after radiotherapy, group A compared with group C, there are significant difference (P < 0.01), group A and group C compared with group B respectively, the difference was statistically significant (P < 0.05). CONCLUSION Nasal endoscope negative pressure cleaning and sinupret drops can significantly reduce the long-term incidence of RNS, especially obviously reduce the incidence of moderate to severe RNS,which is a practical and effective method to treat RNS.
Carcinoma ; Endoscopy ; Humans ; Incidence ; Nasal Cavity ; Nasal Lavage ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Plant Extracts ; administration & dosage ; therapeutic use ; Radiotherapy ; adverse effects ; Sinusitis ; therapy ; Sodium Chloride