Head and neck tumors

The choice of treatment plan for nasopharyngeal carcinoma is related to the severity of the condition, the patient's age, general physical condition, and other factors. The treatment methods for nasopharyngeal carcinoma include radiotherapy, chemotherapy, gene therapy, targeted therapy, and necessary surgery, which may be combined with several treatment methods or participate in clinical trials. Clinical trials are experimental studies conducted around new treatment methods. Treatment method: Radical radiotherapy is the preferred treatment for nasopharyngeal carcinoma. Radiation therapy can achieve long-term survival in 50-70% of nasopharyngeal carcinoma. Radiotherapy includes external radiation therapy (conventional radiotherapy, three-dimensional conformal radiotherapy, intensity modulated conformal radiotherapy, X-knife) and intracavitary brachytherapy. We recommend intensity modulated radiation therapy (IMRT) for newly diagnosed nasopharyngeal carcinoma. This method is very suitable for tumors with complex anatomical structures in the head and neck, and many important and radiation sensitive organs that are closely adjacent to the area to be treated. IMRT can provide good protection for normal tissues while increasing tumor dose. Combination chemotherapy and radiotherapy is the use of cytotoxic drugs to kill tumor cells. Combined chemotherapy is divided into neoadjuvant chemotherapy, concurrent radiotherapy and chemotherapy, and adjuvant chemotherapy. For locally advanced patients, concurrent radiotherapy and chemotherapy is currently recognized as the standard treatment, which involves adding 2-3 cycles of chemotherapy during radiotherapy; During treatment, neoadjuvant and adjuvant chemotherapy can be selected based on the specific situation of the patient. Combined radiotherapy and chemotherapy, especially concurrent radiotherapy and chemotherapy, can improve the local control rate and disease-free survival rate of advanced nasopharyngeal carcinoma. Due to the significant side effects associated with concurrent radiotherapy and chemotherapy, there should be strict dose-increasing clinical research results before using this method. Therefore, patients should be treated at experienced treatment centers. Gene radiotherapy will introduce tumor suppressor genes into tumor tissue through a certain carrier, integrate with tumor cells, and play a role in inhibiting tumor growth. At present, the mature research is the adenovirus mediated P53 gene (trade name: Jinyousheng), which is one of the characteristic treatments for head and neck tumors in our department. It needs to be combined with radiotherapy to increase the sensitivity of tumors to radiotherapy and improve local control. The medication route is intratumoral injection. According to the characteristics of the lesion site, it can be achieved through direct injection, endoscopic injection, ultrasound and CT guided injection, and injection under the localization machine. The clinical results of adenovirus mediated p53 gene combined with radiotherapy for stage II nasopharyngeal carcinoma, led by our hospital, showed that the local control rate and disease-free survival rate of the gene radiotherapy group were higher than those of the simple radiotherapy group. Thermotherapy and radiotherapy can specifically kill S phase cells that are not sensitive to radiation in the cell cycle. During radiotherapy, local hyperthermia has a significant helpful effect on the treatment of large neck tumors that are difficult to regress. Whole body hyperthermia has a reducing and analgesic effect on patients with multiple bone metastases. Surgical treatment of residual cervical lymph nodes after radiotherapy and chemotherapy can be performed at an appropriate time. Surgical resection can also be chosen for localized lesions that recur after radical radiotherapy. Targeted therapy for epidermal growth factor receptor (EGFR) is a transmembrane tyrosine kinase receptor that plays a crucial role in the pathological process of head and neck cancer. EGFR is overexpressed in almost all head and neck squamous cell carcinoma. Research has shown that excessive expression of EGFR is associated with poor prognosis of tumors and the tolerance of tumor cells to radiotherapy and chemotherapy. Numerous preclinical studies have shown that inhibiting EGFR can improve the efficacy of radiotherapy. After sufficient radiotherapy and chemotherapy, there is still a possibility of recurrence and metastasis in nasopharyngeal carcinoma, and there are still effective treatment methods and good clinical results for early detection of lesions. Therefore, regular follow-up is very important. In general, within two years after the completion of treatment, the follow-up time is once every three months, and the interval can be gradually extended after two years.