The preferred radiotherapy for nasopharyngeal cancer? Not necessarily
The preferred radiotherapy for nasopharyngeal cancer? Not necessarily January 03, 2019 Source: Guangzhou Daily Nasopharyngeal carcinoma is a kind of malignant tumor originating from the mucosa of the nasopharynx. It is also the most common malignant tumor of the head and neck in China. Because nasopharyngeal carcinoma is mostly poorly differentiated squamous cell carcinoma and has high sensitivity to radiation, radiotherapy is often the preferred treatment for nasopharyngeal carcinoma. However, it also produces a variety of unavoidable complications while improving patient survival. Professor Qiu Qianhui, director of the Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, said that the preferred radiotherapy is not the "absolute standard" for the treatment of nasopharyngeal carcinoma. The combination of surgery and chemotherapy, especially in the early stage of nasopharyngeal cancer, can not reduce the survival rate. Significantly improve side effects and improve the quality of life of patients. Radiotherapy is preferred in early patients Not an "absolute standard" Qiu Qianhui said that nasopharyngeal carcinoma has high sensitivity to radiotherapy, so radiotherapy has become the treatment of choice for most people. At present, with the advancement of radiotherapy technology and the continuous improvement of the program, the 5-year survival rate of patients with primary nasopharyngeal carcinoma can reach more than 90%. However, radiotherapy is also a double-edged sword, which kills tumor cells and damages normal tissues and organs, leading to a series of unavoidable side effects - mucosal damage, difficulty in swallowing, fibrosis of the neck, etc. The quality of life of the patient. Most of the tumors are cured by surgery. The difference in nasopharyngeal carcinoma is that the position of the nasopharyngeal cavity is deep and narrow. There are many important blood vessels, nerves and lymphatic tissues in the vicinity, which makes the surgery more difficult. "But it's difficult, it doesn't mean it's not good or impossible." Qiu Qianhui said that in fact, from the follow-up results of nearly a thousand patients with nasopharyngeal carcinoma who have been treated for many years, for patients with nasopharyngeal cancer who are eligible, especially It is an early non-metastatic patient, endoscopic surgery combined with chemotherapy, the 5-year survival rate is also as high as 90%, and the quality of life is evaluated, which is significantly better than radiotherapy patients. The operation is performed by endoscopic surgery, and then 4 to 6 courses of chemotherapy are required, starting about 1 week after surgery. Local recurrence Endoscopic surgery Although the 5-year survival rate is higher in patients with primary nasopharyngeal carcinoma after conventional radiotherapy, 8.6% to 23.7% of patients have recurrence of nasopharyngeal and cervical lymph nodes within 5 years and need to be treated again. For patients with recurrent nasopharyngeal carcinoma, can they only choose re-radiation and chemotherapy? Qiu Qianhui said that the tumor cells that relapsed after radiotherapy were left after the first treatment. Most of the tumor cells that survived were not sensitive to radiation or chemotherapy drugs. Secondly, the radiation may change the pathological type of the primary tumor and cause local Tissue scarring and blood supply disorders, once the tumor recurs, its sensitivity to re-radiation is greatly reduced. In addition, due to the presence of these tolerant tumor cells in the lesions of recurrent nasopharyngeal carcinoma, re-radiation requires a larger dose of radiation to have sufficient therapeutic effects, which may mean more and more serious adverse reactions, such as Leukopenia, severe infection, major bleeding in the nose, intractable headache, difficulty in opening the mouth, difficulty in swallowing, etc. The current clinical studies report that the 5-year survival rate of patients with secondary radiotherapy or secondary concurrent chemoradiotherapy is no more than 40%, and the incidence of serious adverse reactions is close to 50%. In recent years, with the advancement of endoscopic techniques and the development of endoscopic skull base surgery, the anatomy of the nasopharynx and surrounding skull base tissue has progressed in depth, and the complete removal of nasopharyngeal carcinoma tissue can be achieved. Therefore, Qiu Qianhui said that endoscopic surgery is also a good choice for patients with locally recurrent nasopharyngeal carcinoma. "In addition to complete resection of the tumor, endoscopic surgery can reduce the nasopharyngeal necrotic tissue and use the mucosal flap to repair the nasopharyngeal wound. It can not only restore the physiological function of the nasopharyngeal mucosa, but also solve the recurrent nasopharyngeal. The problem of difficult healing of cancer wounds can significantly improve symptoms such as intractable headache after radiotherapy." remind: Be alert to these symptoms Although nasopharyngeal carcinoma is highly prevalent, early nasopharyngeal cancer is not typical and is often easily overlooked, causing delays. Qiu Qianhui reminded that the following symptoms may often be a precursor to nasopharyngeal cancer, and it is necessary to be alert to seek medical advice. 1. Nasal congestion, blood stasis: In the early stage of nasopharyngeal carcinoma, blood may be present in the sinus, sometimes not. The enlargement of the tumor may block the posterior nostril, causing unilateral or bilateral nasal congestion. 2. Tinnitus, hearing loss: Nasopharyngeal carcinoma, which occurs in the pharyngeal recess, can compress or block the eustachian tube pharynx in the early stage, causing tinnitus, ear closure and hearing loss. The tympanic effusion is clinically misdiagnosed as secretory otitis media. 3. Cervical lymphadenopathy: More common in patients with cervical lymph node metastasis of nasopharyngeal carcinoma, the patient may find that the neck has a long mass, and the longer it grows, the texture is very hard and the pressure is not painful. At first, only one side is long, and then both sides of the neck may grow. 4. Cranial nerve symptoms: The tumor grows into the cranium, and the invasion of the cranial nerve can cause headache, facial numbness, limited abduction of the eye, and symptoms such as ptosis; the tumor directly invades or metastasizes to the cranial nerve after compression of the lymph node, which can cause soft palate, cough, and sound.嘶, stretched tongue and other symptoms. Fire Alarm By Room,Smoke Alarm By Room,Room Smoke Alarm,Room Smoke Alarms Guangdong Isafenest Co.,Ltd. , https://www.isfenest.com