The suffering of chemotherapy!The study of nasopharyngeal cancer led by Professor Ma Jun conveyed this information ... | 2022 ASCO Voice of China

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Learn new progress in the field of ASCO conference in the field of nasopharynx cancer!

In 2022, the United States Clinical Oncology Society (ASCO) conference was held on June 3-7 local time. At this meeting, many domestic studies were included in ASCO verbal reports in the field of head and neck tumors. Light". Cancer Channel of the medical community invites Professor Ma Jun, the Cancer Prevention and Treatment Center of Sun Yat -sen University. Studies (Abstract No.: 6000) Share relevant opinions and look forward to the latest progress in the field of nasopharyngeal cancer treatment.

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Patients with a very low risk of metastasis are used to use simple radiotherapy

Radiation treatment is the treatment method of nasopharyngeal cancer. Phase I patients use simple radiotherapy. Patients in phase II and phase III in phase III are recommended for radiotherapy combined with chemotherapy in the same period. Auxiliary chemotherapy or maintenance treatment.

Talking about the unsatisfactory clinical needs of nasopharyngeal cancer at present, Professor Ma Jun said: "How to further combine the prognostic indicators on the basis of staging, which is an urgent need to solve the problem of layered treatment."

The previous NCCN guidelines recommended Phase II patients for radiotherapy combined with the same period of chemotherapy. The main evidence comes from the era of two -dimensional regular radiotherapy. The main role of chemotherapy in the same period is to increase the sensitivity of radiotherapy, improve the local control rate, kill the tiny metastases, and reduce the distant metastasis. With the widespread application of strengthening radiation therapy, the local control rate of nasopharynx cancer has been significantly improved, and the local control rate of patients with phase II and T3N0 can reach more than 90%.

However, Professor Ma Jun also said frankly: "At the same time, the sensitivity of chemotherapy and chemotherapy also significantly increased the gastrointestinal reactions such as patients' nausea, vomiting, etc., causing the patient's weight loss, and the decrease in weight loss is the prognosis of the prognosis of nasopharyngeal cancer."

Professor Ma Jun talked: "Obviously, chemotherapy is difficult to achieve on this basis, then if we screen patients with a very low risk of metastasis, it is feasible to use simple radiotherapy. Therefore, this study first selected phases II and III. The T3N0 sub-group of the period, this installment patient has a small tumor load and a high local control rate. At the same time, patients with bad prognosis factors are ruled out: extra envelope invasion, lymph nodes> 3cm, lymph nodes reach the IV/V area, EBV- DNA> 4000, so that patients with low risk of recurrence and metastasis will be screened, and simple radiotherapy is used. "Simple and strong radiation therapy is used as the preferred treatment strategy

In this study, the survival rate of simplicity and radiation therapy group for three years was 90.6%, and 91.9%of the radiotherapy group was 91.9%in the same period. The survival rate of the two groups was statistically different. In terms of toxicity and sub-reaction, there was a significant increase in toxic response in the same period of the radiotherapy group. The radiological radiation therapy group was compared with the 3-4 toxic comparison of level 3-4 in the same period. 17 cases of VS (10%), 3 cases (2%) VS (7%) (7%), 1 case (1%) vs (13%), 2 cases of vomiting (1%) VS 25 cases (15%), 8 cases of appetite (5%) vs 49 cases (29%), 1 case (1%) 8 cases (5%), 16 cases of mucositis (10%) vs 32 cases 32 cases 32 cases (19%).

Professor Ma Jun said: "Our research results show that the efficacy of simplicity and strong radiation treatment for patients with low -risk patients is not less than that of chemotherapy at the same time, and toxic and sideline reactions are significantly alleviated, which can be used as the preferred treatment strategy. Systemic chemotherapy may play a good chemotherapy. Radio treatment and eliminate the effects of small metastatic lesions. For patients with high metastasis or recurrence of high -risk factors, chemotherapy is still needed. "

The sparkling nasopharyngeal cancer "Voice of China"

In addition, at this ASCO Annual Meeting, Professor Mai Haiqiang's team carried out a phase II clinical study of the radiotherapy dose of late nasopharyngeal cancer for low -risk local regions. In this study, patients with EBV DNA <4000 Copies/ML patients with EBV DNA <4000 Copies/ML before treatment, according to whether the efficacy after inducing chemotherapy has achieved a complete relief (CR) or partial relief (PR), and whether the EBV DNA after chemotherapy is reduced to 0, screening Patients with sensitive chemotherapy.

For this part of the patient, after inducing chemotherapy, the radiotherapy dose of chemotherapy during the same period was reduced from 70GY to 60GY. The study was entered into 116 patients. %, The survival rate of 2 years without recurrence is 97%. Patients have good prognosis, and the incidence of acute and chronic virus -side reactions during the treatment of leukocytes, anemia, hyperthyroidism, and long -term sequelae (dry mouth, neck skin fibrosis, etc.) have significantly reduced.

At the same time, the Rationale-309 updated survival data and the results of the research on the Rationale-309 of the ASCO Annual Conference have reported the report of the entire conference series (ASCO PLENARY Series Program). In addition, the Nichuzumab combined with chemotherapy VS placeotherapy and chemotherapy therapy for local advanced nasopharyngeal cancer patients led by Professor Sun Yan of Peking University Cancer Hospital. It is also worth looking forward to.

Expert Introduction

Professor Ma Jun

The executive vice president, professor, and doctoral supervisor of the Sun Yat -sen University Tumor Prevention and Treatment Center is committed to the study of the clinical stages of nasopharyngeal cancer, comprehensive treatment, and accurate strengthening radiation therapy.

Currently the first chairman of the China Clinical Oncology Association Nasopharyngeal Cancer Committee, the convener of the Special Medical Review Team of the State Council's Degree Committee, won the first national innovation competition award, Wu Jieping Pharmaceutical Innovation Award, National Excellent Science and Technology Workers, and National Talent Projects Highlight the honorary titles such as young and middle -aged experts.

As a communication author, there are more than 230 articles on SCI, including the top medical journal Nejm (IF 91), Lancet (IF 79,2), JCO (IF 44), BMJ (IF 39). , 5), Jama Oncol (IF 31,2).

As the chairman, the "Guidelines for the diagnosis and treatment of nasopharyngeal cancer of the Chinese-the United States Clinical Oncology Society" has provided "Chinese wisdom" for the diagnosis and treatment of international nasopharyngeal cancer. It is also the first in the medical field. International evidence -based guide. With the first completion of the "Second Prize of National Science and Technology Progress" (2009 and 2015), the results were selected into the "Top Ten Science and Technology Progress of China College (2012 and 2019)

Expert Introduction

Professor Tang Linglong

The chief physician and doctoral supervisor of the Cancer Hospital of Sun Yat -sen University, dedicated to the study of the clinical stage of nasopharyngeal carcinoma and accurate strengthening radiation therapy.

In the past 5 years, 34 SCI papers have been published as the first or communication authors, including Lancet, Lancet Oncol, J Natl Compr CANC NETW, CLIN CANCER Res, Cancer Communi, etc.

Four research results were accepted by international guidelines, 4 research results were adopted by domestic guidelines and won the second prize of the 2009 National Science and Technology Progress (Fifth Complete), 2020 "Guangdong Provincial Medical Science and Technology First Prize" and "Scientific Research on Higher SchoolThe first prize of the results (the 5th and 10th completion of the people), the 2021 "First Prize of Science and Technology Progress in Guangdong Province" (7th), and was rated as the "People's Good Doctor" (Nasopharyngeal Cancer "by the People's Daily Online in 2020field).The first release of this article: the medical world tumor channel

Author of this article: Dali

Editor in charge: Sweet

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