2015年第一版《NCCN头颈部肿瘤临床实践指南》
关于鼻咽癌更新内容及要点解读
杨青廷 熊文婧 刘 也 刘 洋 让蔚清*
【摘要】本文就2015 年头颈部肿瘤V1 版美国国立综合癌症网络(NCCN）指南关于鼻咽癌的变更重点内容和要点做一解读，内容包括：对原发灶进行活检或者进行颈部超声引导下细针穿刺活检；考虑进行EBV检查或DNA检查；考虑进行眼科和内分泌检查用于评估临床指征；删除了，当放化疗结合化疗的时候，顺铂作为一类用药；单纯放疗剂量修改为66Gy（每次2.2Gy进行分割）到70 - 70.2Gy（每次1.8 - 2.0Gy进行分割），同步放化疗时放疗剂量修改为70-70.2Gy（每次1.8 - 2.0Gy进行分割）。NCCN 临床实践指南为临床提供了借鉴，由于种族不同、地域有别以及肿瘤的异质性，更新后的标准需要接受临床实践的检验才能达到进一步完善。
【关键词】鼻咽癌；美国国立综合癌症网络；放疗；化疗
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