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Early Stage and Locally Advanced Nasopharyngeal Carcinoma Treatment from Present to Future: Where Are We and Where Are We Going?
Juarez-Vignon Whaley, Juan Jose; Afkhami, Michelle; Sampath, Sagus; Amini, Arya; Bell, Diana; Villaflor, Victoria M.
Afiliação
  • Juarez-Vignon Whaley JJ; Health Science Research Center, Faculty of Health Science, Universidad Anahuac Mexico, State of Mexico, Mexico City, Mexico.
  • Afkhami M; Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
  • Sampath S; Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
  • Amini A; Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
  • Bell D; Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
  • Villaflor VM; Department of Medical Oncology, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA. vvillaflor@coh.org.
Curr Treat Options Oncol ; 24(7): 845-866, 2023 Jul.
Article em En | MEDLINE | ID: mdl-37145382
OPINION STATEMENT: Nasopharyngeal carcinoma (NPC) is a rare malignancy, endemic in China, that is commonly diagnosed in locally advanced scenarios. Its pathogenesis is strongly associated with Epstein-Barr virus (EBV), an infection for which measuring EBV plasma DNA levels has helped as a prognostic factor guiding treatment options, including a stronger treatment in those with high titers. Additionally, tobacco and alcohol are often implicated in EBV-negative patients. The local disease is treated with radiotherapy alone, preferentially intensity modulated radiotherapy. For locally advanced disease, the backbone treatment is concurrent chemoradiotherapy with the ongoing research dilemma being adding adjuvant chemotherapy or induction chemotherapy. The ongoing research is focused not only on identifying patients that will benefit from adjuvant or induction chemotherapy, but also on identifying the best chemotherapeutic regimen, regimen alternatives to diminish toxicity, the role that immune checkpoint inhibitors play, and the use of molecularly guided treatment targeting patients with NPC whether driven by EBV or tobacco and alcohol. Knowing the precise oncogenesis of NPC not only offers a better understanding of the role that EBV plays in this tumor but also helps create targeted therapies that could potentially block important pathways such as the NF-κB pathway. Much is yet to be done, but the prognosis and management of NPC patients have changed drastically, offering precise treatment methods and excellent control of the disease, even in locally advanced scenarios.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Nasofaríngeas / Infecções por Vírus Epstein-Barr Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Curr Treat Options Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2023 Tipo de documento: Article País de afiliação: México País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Nasofaríngeas / Infecções por Vírus Epstein-Barr Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Curr Treat Options Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2023 Tipo de documento: Article País de afiliação: México País de publicação: Estados Unidos