Sate of Art of Stereotaxic Techniques for Recurrent Nasopharyngeal Carcinoma

Sophia Lebbar, M. Darfaoui, A. Omrani, M. Khouchani
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Abstract

Recurrent nasopharyngeal carcinoma (NPC) is a challenging condition to treat, requiring effective strategies due to its aggressiveness and resistance to conventional therapies. Stereotactic techniques, including stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), have emerged as promising options for managing recurrent NPC. These techniques deliver highly precise radiation doses to the tumor while minimizing damage to surrounding healthy tissues, maximizing tumor control, and reducing side effects. This review explored the current evidence and clinical outcomes of stereotactic techniques in managing recurrent NPC. A systematic review was conducted using PubMed as the primary database, and 58 relevant articles were analyzed. The selected studies demonstrated the efficacy of stereotactic techniques, with high response rates and favorable local control and survival rates reported in various cohorts. However, the review also noted the potential risk of complications associated with stereotactic techniques, including late toxicities such as radionecrosis or hemorrhage. While the studies showed promising results, the level of evidence was primarily based on retrospective analyses and some pilot and prospective studies, highlighting the need for further validation and longer-term follow-up. More research is required to establish optimal protocols, minimize risks, and further understand the role of these techniques in improving patient outcomes.
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鼻咽癌复发的立体定位技术现状
复发性鼻咽癌(NPC)是一种具有挑战性的疾病,由于其侵袭性和对常规治疗的抵抗,需要有效的策略。立体定向技术,包括立体定向放射外科(SRS)和立体定向全身放射治疗(SBRT),已经成为治疗复发性鼻咽癌的有希望的选择。这些技术向肿瘤提供高度精确的辐射剂量,同时最大限度地减少对周围健康组织的损害,最大限度地控制肿瘤,并减少副作用。这篇综述探讨了立体定向技术治疗复发性鼻咽癌的现有证据和临床结果。以PubMed为主要数据库进行系统综述,对58篇相关文章进行分析。所选的研究证明了立体定向技术的有效性,在不同的队列中报告了高有效率和有利的局部控制和生存率。然而,该综述也指出了与立体定向技术相关的并发症的潜在风险,包括放射性坏死或出血等晚期毒性。虽然这些研究显示出令人鼓舞的结果,但证据水平主要基于回顾性分析和一些试点和前瞻性研究,强调需要进一步验证和长期随访。需要更多的研究来建立最佳方案,最大限度地降低风险,并进一步了解这些技术在改善患者预后方面的作用。
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