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Book Chapter: Management of nasopharyngeal carcinoma

TitleManagement of nasopharyngeal carcinoma
Authors
Editors
Editor(s):Bernier, J
KeywordsNasopharyngeal carcinoma
Radiotherapy
Chemotherapy
Salvage treatment
Late toxicity
Issue Date2016
PublisherSpringer
Citation
Management of nasopharyngeal carcinoma. In Bernier, J (Ed.), Head and Neck Cancer: Multimodality Management (2nd ed.), p. 445-473. Switzerland: Springer, 2016 How to Cite?
AbstractNasopharyngeal carcinoma is a distinctly radiosensitive and chemosensitive tumor. Best quality radiotherapy is demanded to build up the complex concave high-dose zone for this critical location. Intensity-modulated radiotherapy (IMRT) is advocated; image guidance to ensure setup precision and adaptive re-planning if major deviations from intended dose distribution occur during the treatment course are useful improvements if resources allow. Stringent dose constraint to organs at risk should be attempted to minimize late toxicities. Addition of cisplatin-based concurrent-adjuvant chemotherapy is recommended for patients with stages III–IVB and high-risk stage IIB diseases. Contemporary series using IMRT together with extensive use of chemotherapy reported very encouraging long-term results with locoregional control in excess of 85 % at 5 years; the key remaining problems are advanced T4 disease and distant failure. Further improvement of efficacy by more potent systemic therapy and changing chemotherapy sequence to induction-concurrent is being explored. The plasma level of Epstein–Barr Viral Deoxyribonucleic Acid is a well-established tool for non-keratinizing carcinoma for prognostication and monitoring disease progress. Integrated fluorodeoxyglucose positron emission tomography and computed tomography is useful for excluding distant metastases and posttreatment persistent/recurrent disease. Early detection of failure is critical; and aggressive treatment should be attempted as long survival could be achieved for patients with limited failure. Different salvage methods and reported results are summarized.
Persistent Identifierhttp://hdl.handle.net/10722/220037
ISBN

 

DC FieldValueLanguage
dc.contributor.authorNg, WT-
dc.contributor.authorNgan, RKC-
dc.contributor.authorChan, OSH-
dc.contributor.authorSze, CKH-
dc.contributor.authorChan, JYW-
dc.contributor.authorLee, WMA-
dc.contributor.editorBernier, J-
dc.date.accessioned2015-10-16T06:16:37Z-
dc.date.available2015-10-16T06:16:37Z-
dc.date.issued2016-
dc.identifier.citationManagement of nasopharyngeal carcinoma. In Bernier, J (Ed.), Head and Neck Cancer: Multimodality Management (2nd ed.), p. 445-473. Switzerland: Springer, 2016-
dc.identifier.isbn9783319275994-
dc.identifier.urihttp://hdl.handle.net/10722/220037-
dc.description.abstractNasopharyngeal carcinoma is a distinctly radiosensitive and chemosensitive tumor. Best quality radiotherapy is demanded to build up the complex concave high-dose zone for this critical location. Intensity-modulated radiotherapy (IMRT) is advocated; image guidance to ensure setup precision and adaptive re-planning if major deviations from intended dose distribution occur during the treatment course are useful improvements if resources allow. Stringent dose constraint to organs at risk should be attempted to minimize late toxicities. Addition of cisplatin-based concurrent-adjuvant chemotherapy is recommended for patients with stages III–IVB and high-risk stage IIB diseases. Contemporary series using IMRT together with extensive use of chemotherapy reported very encouraging long-term results with locoregional control in excess of 85 % at 5 years; the key remaining problems are advanced T4 disease and distant failure. Further improvement of efficacy by more potent systemic therapy and changing chemotherapy sequence to induction-concurrent is being explored. The plasma level of Epstein–Barr Viral Deoxyribonucleic Acid is a well-established tool for non-keratinizing carcinoma for prognostication and monitoring disease progress. Integrated fluorodeoxyglucose positron emission tomography and computed tomography is useful for excluding distant metastases and posttreatment persistent/recurrent disease. Early detection of failure is critical; and aggressive treatment should be attempted as long survival could be achieved for patients with limited failure. Different salvage methods and reported results are summarized.-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofHead and Neck Cancer: Multimodality Management (2nd ed.)-
dc.subjectNasopharyngeal carcinoma-
dc.subjectRadiotherapy-
dc.subjectChemotherapy-
dc.subjectSalvage treatment-
dc.subjectLate toxicity-
dc.titleManagement of nasopharyngeal carcinoma-
dc.typeBook_Chapter-
dc.identifier.emailNg, WT: ngwt1@hkucc.hku.hk-
dc.identifier.emailNgan, RKC: rkcngan@hkucc.hku.hk-
dc.identifier.emailChan, OSH: chansh2@hku.hk-
dc.identifier.emailSze, CKH: henrysze@graduate.hku.hk-
dc.identifier.emailChan, JYW: jywchan1@HKUCC-COM.hku.hk-
dc.identifier.emailLee, WMA: awmlee@hkucc.hku.hk-
dc.identifier.authoritySze, CKH=rp01697-
dc.identifier.authorityChan, JYW=rp01314-
dc.identifier.authorityLee, WMA=rp02056-
dc.identifier.doi10.1007/978-3-319-27601-4_26-
dc.identifier.hkuros265588-
dc.identifier.spage445-
dc.identifier.epage473-
dc.publisher.placeSwitzerland-

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