2015年第一版《NCCN頭頸部腫瘤臨床實(shí)踐指南》

關(guān)于鼻咽癌更新內(nèi)容及要點(diǎn)解讀

楊青廷   熊文婧   劉  也 劉  洋   讓蔚清^*

    【摘要】本文就2015 年頭頸部腫瘤V1 版美國(guó)國(guó)立綜合癌癥網(wǎng)絡(luò)(NCCN）指南關(guān)于鼻咽癌的變更重點(diǎn)內(nèi)容和要點(diǎn)做一解讀，內(nèi)容包括：對(duì)原發(fā)灶進(jìn)行活檢或者進(jìn)行頸部超聲引導(dǎo)下細(xì)針穿刺活檢；考慮進(jìn)行EBV檢查或DNA檢查；考慮進(jìn)行眼科和內(nèi)分泌檢查用于評(píng)估臨床指征；刪除了，當(dāng)放化療結(jié)合化療的時(shí)候，順鉑作為一類用藥；單純放療劑量修改為66Gy（每次2.2Gy進(jìn)行分割）到70 - 70.2Gy（每次1.8 - 2.0Gy進(jìn)行分割），同步放化療時(shí)放療劑量修改為70-70.2Gy（每次1.8 - 2.0Gy進(jìn)行分割）。NCCN 臨床實(shí)踐指南為臨床提供了借鑒，由于種族不同、地域有別以及腫瘤的異質(zhì)性，更新后的標(biāo)準(zhǔn)需要接受臨床實(shí)踐的檢驗(yàn)才能達(dá)到進(jìn)一步完善。

    【關(guān)鍵詞】鼻咽癌；美國(guó)國(guó)立綜合癌癥網(wǎng)絡(luò)；放療；化療

2015 NCCN clinical practice guidelines in oncology：interpretation of nasopharynx cancer,Yang Qingting, Xiong Wenjing, Liu Ye, Liu Yang, Rang Weiqing, Yang Qingting, Liu Ye, Liu Yang,Rang Weiqing, University of South China, Hengyang 421001, Hunan, China; Xiong Wenjing, Beijing University of Chinese Medicine. Beijing 100029,China

    【Abstract】The updates of NCCN clinical practice guidelines for oncology 2015 V1 on Cancer of the Nasopharynx include: Biopsy of primary site or FNA of the neck; Considering EBV/DNA testing; considering ophthalmologic and endocrine evaluation as clinically indicators; removing cisplatin as adjuvant chemotherapy. When using concurrent chemotherapy/RT; RT dose is revised from 66Gy (2.2 Gy as a fraction) to 70-70.2Gy (1.8-2.0 Gy as a fraction), Concurrent Chemoradiation RT dose is revised as 70-70.2 Gy (1.8-2.0 Gy as a fraction). NCCN clinical practice guidelines for oncology offer sufficient information for clinic. However, due to the differences of race, region and the heterogeneity of tumor, the new updates need to become better through the clinical practice.

    【Key words】nasopharynx cancer；national comprehensive cancer network (NCCN)；radiotherapy；chemotherapy