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Characteristic And Novel Therapeutic Strategies Of Nasopharyngeal Carcinoma With Synchronous Metastasis

Authors Liao W, Tian M, Chen N

Received 19 June 2019

Accepted for publication 5 September 2019

Published 16 September 2019 Volume 2019:11 Pages 8431—8442


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5

Editor who approved publication: Professor Rudolph Navari

Wenjun Liao, Maolang Tian, Nianyong Chen

Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China

Correspondence: Nianyong Chen
Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China
Tel +86 28 8542 3278
Fax +86 28 8542 2952

Abstract: Nasopharyngeal carcinoma (NPC) is rare in Western countries, but its incidence in China and Southeast Asia is notably high. NPC shows a high rate of distant metastasis including metachronous metastasis (mmNPC, metastasis after definitive chemo-radiotherapy) and synchronous metastasis (smNPC, metastasis at initial diagnosis). 4–10% of patients would be diagnosed as smNPC annually, and the survival outcomes of these patients are quite poor. As with few clinical trials exclusively focusing on this population, treatment on smNPC is not unified and many problems remain unsolved. To date, systematic chemotherapy (CT) still remains a fundamental treatment in smNPC. Although no randomized trial has been conducted to compare different CT regimens in smNPC, gemcitabine and taxanes in combination with platinum seem optimal in first-line setting. In second-line CT, there is no consensus: mono-chemotherapy with drugs such as gemcitabine, taxanes or capecitabine could be taken into consideration. Immunotherapy based on checkpoint inhibitors shows promising efficacy both in first-line and in the following lines of therapy. In addition to CT, local therapy in smNPC is also very important. Locoregional radiotherapy (RT) for primary tumor in combination with CT could strikingly increase OS with acceptable toxicities. And local treatment, such as surgery and RT, for metastatic lesions could bring extra survival benefit in patients with solitary or limited metastases. Overall, the present study provides an overview of the literature on the various studies of smNPC.

Keywords: nasopharyngeal carcinoma, radiotherapy, chemotherapy, immunotherapy, metachronous

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