Kết quả xạ trị củng cố ung thư vòm mũi họng giai đoạn IVB tại Bệnh viện K

Le Thi Hoa, Nguyen Van Dang

Main Article Content

Abstract

Nasopharyngeal carcinoma is one of the most common head and neck cancers. Consolidation radiotherapy following chemotherapy in patients with newly diagnosed metastatic disease has been proven to improve local disease control and prolong survival without significantly increasing toxicity. This study was conducted on 60 patients with stage IVB nasopharyngeal carcinoma treated with consolidation radiotherapy after chemotherapy at Vietnam National Cancer Hospital from January 2017 to December 2024. The study showed an overall response rate of 81.7% after consolidation radiotherapy. The 12-month overall survival rate and progression-free survival rate were 82.6% and 64.5%, respectively. Acute grade 3 or higher dermatitis and mucositis were rare. The results suggest that this treatment regimen offers favorable outcomes with good tolerability. However, further research is needed to evaluate this approach's long-term efficacy and potential late toxicities.

Article Details

References

1. Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. The Lancet. 2019; 394(10192): 64-80. doi:10.1016/S0140-6736(19)30956-0.
2. Liu Q, Li J, Ng WT, Lee AWM. Treatment strategy for de novo metastatic nasopharyngeal carcinoma: a literature review. Chinese Clinical Oncology. 2023; 12(4): 43-43. doi:10.21037/cco-23-32.
3. Zhang L, Huang Y, Hong S, et al. Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma: a multicentre, randomised, open-label, phase 3 trial. The Lancet. 2016; 388(10054): 1883-1892. doi:10.1016/S0140-6736(16)31388-5.
4. Bensouda Y, Kaikani W, Ahbeddou N, et al. Treatment for metastatic nasopharyngeal carcinoma. Eur Ann Otorhinolaryngol Head Neck Dis. 2011; 128(2): 79-85. doi:10.1016/j.anorl.2010.10.003.
5. Huang T, Su N, Zhang X, et al. Systemic chemotherapy and sequential locoregional radiotherapy in initially metastatic nasopharyngeal carcinoma: Retrospective analysis with 821 cases. Head Neck. 2020; 42(8): 1970-1980. doi:10.1002/hed.26130.
6. Li WZ, Lv SH, Liu GY, et al. Development of a Prognostic Model to Identify the Suitable Definitive Radiation Therapy Candidates in de Novo Metastatic Nasopharyngeal Carcinoma: A Real-World Study. Int J Radiat Oncol Biol Phys. 2021; 109(1): 120-130. doi:10.1016/j.ijrobp.2020.08.045.
7. Hu J, Kong L, Gao J, Hu W, Guan X, Lu JJ. Use of Radiation Therapy in Metastatic Nasopharyngeal Cancer Improves Survival: A SEER Analysis. Sci Rep. 2017; 7(1): 721. doi:10.1038/s41598-017-00655-1.
8. Zheng W, Zong J, Huang C, et al. Multimodality Treatment May Improve the Survival Rate of Patients with Metastatic Nasopharyngeal Carcinoma with Good Performance Status. PLoS One. 2016; 11(1): e0146771. doi:10.1371/journal.pone.0146771.
9. Rusthoven CG, Lanning RM, Jones BL, et al. Metastatic nasopharyngeal carcinoma: Patterns of care and survival for patients receiving chemotherapy with and without local radiotherapy. Radiother Oncol. 2017; 124(1): 139-146. doi:10.1016/j.radonc.2017.03.019.
10. Lin S, Tham IWK, Pan J, Han L, Chen Q, Lu JJ. Combined high-dose radiation therapy and systemic chemotherapy improves survival in patients with newly diagnosed metastatic nasopharyngeal cancer. Am J Clin Oncol. 2012; 35(5): 474-479. doi:10.1097/COC.0b013e31821a9452.
11. You R, Liu YP, Huang PY, et al. Efficacy and Safety of Locoregional Radiotherapy With Chemotherapy vs Chemotherapy Alone in De Novo Metastatic Nasopharyngeal Carcinoma: A Multicenter Phase 3 Randomized Clinical Trial. JAMA Oncology. 2020; 6(9): 1345-1352. doi:10.1001/jamaoncol.2020.1808.
12. Bossi P, Chan AT, Licitra L, et al. Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2021; 32(4): 452-465. doi:10.1016/j.annonc.2020.12.007.
13. head-and-neck.pdf. Accessed December 17, 2023. https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf.
14. Li WZ, Hua X, Xie DH, et al. Prognostic model for risk stratification of de novo metastatic nasopharyngeal carcinoma patients treated with chemotherapy followed by locoregional radiotherapy. ESMO Open. 2021; 6(1). doi:10.1016/j.esmoop.2020.100004.
15. Wang G, Shen L. The efficacy of locoregional radiotherapy plus chemotherapy vs. chemotherapy alone in metastatic nasopharyngeal carcinoma: a meta-analysis. Annals of Palliative Medicine. 2021; 10(3): 2584595-2582595. doi:10.21037/apm-20-1561.