Annals of nasopharynx cancer最新文献

{"title":"A protocol for international consensus guideline development on the delineation of radiotherapy target volumes for nasopharyngeal carcinoma after induction chemotherapy","authors":"Warren Bacorro, N. Fourati, Hela Hammami Turki, Ryan Anthony Agas, Omar Nouri, Lester Bryan Co, Audrey Larnaudie, Clevelinda S. Calma, Melvin L. K. Chua, Michael Benedict Mejia, Jamel Daoud","doi":"10.21037/anpc-23-1","DOIUrl":"https://doi.org/10.21037/anpc-23-1","url":null,"abstract":"","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Epstein-Barr virus (EBV) antibodies as screening markers for nasopharyngeal carcinoma: a narrative review.","authors":"Sweta Sinha,&nbsp;Brittney L Dickey,&nbsp;Anna E Coghill","doi":"10.21037/anpc-21-12","DOIUrl":"https://doi.org/10.21037/anpc-21-12","url":null,"abstract":"<p><strong>Background and objective: </strong>Nasopharyngeal carcinoma (NPC) is a tumor of the head and neck that arises from the mucosal epithelium of the nasopharynx. Epstein-Barr virus (EBV) is a human herpes virus and the necessary cause for NPC. The 5-year survival rate for NPC patients is higher when diagnosed at an earlier stage of disease. Therefore, NPC screening should be prioritized for early detection. The objective of this narrative review is to synthesize the existing literature from the past decade describing evaluations of EBV-based serological markers for NPC screening.</p><p><strong>Methods: </strong>We performed a literature search in PubMed for studies published from 2010 to 2020. Studies were required to be English-language articles. Twelve articles fulfilled all inclusion criteria, including eight studies conducted among the general population in southeastern China, three studies in genetically high-risk Taiwanese families, and one study comparing EBV serology versus circulating EBV DNA for NPC prediction.</p><p><strong>Key content and findings: </strong>Studies suggest that EBV-based serology has the potential to be an effective tool to aid in early detection of NPC. The synthesized research also collectively suggests that incorporation of antibody against multiple EBV targets, as well as efforts to optimize assay output, can improve the ability of EBV serological markers to detect NPC. Finally, recent data from the only randomized trial provide preliminary evidence that screening using anti-EBV immunoglobulin A (IgA) antibody may achieve the goal of reducing mortality from NPC.</p><p><strong>Conclusions: </strong>Late diagnosis is one of the reasons for poor survival after an NPC diagnosis. In high-risk areas, early diagnosis aided by EBV antibody could therefore improve survival.</p>","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":"6 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/6b/nihms-1826163.PMC9392954.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40632697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classifying the tumor microenvironment to stratify nasopharyngeal carcinoma patients","authors":"Shangxin Liu, Ge‐Xin Zhao, Ruo-Bin Lin, M. Zeng, Qian Zhong","doi":"10.21037/anpc-21-10","DOIUrl":"https://doi.org/10.21037/anpc-21-10","url":null,"abstract":"","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44199277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The etiology of nasopharyngeal carcinoma and challenges for its diagnosis and treatment monitoring","authors":"M. Lung","doi":"10.21037/anpc-21-8","DOIUrl":"https://doi.org/10.21037/anpc-21-8","url":null,"abstract":"","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44386735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EBV and NPC carcinogenesis—an alternative viewpoint","authors":"S. Poh, J. Wee","doi":"10.21037/anpc-21-1","DOIUrl":"https://doi.org/10.21037/anpc-21-1","url":null,"abstract":"© Annals of Nasopharynx Cancer. All rights reserved. Ann Nasopharynx Cancer 2021;5:4 | https://dx.doi.org/10.21037/anpc-21-1 The etiology of nasopharyngeal carcinoma (NPC) has been causally linked to environmental and ethnic factors. In this article, we aim to put forward a proposed mechanism linking Epstein Barr Virus (EBV) infection to the observed ethnic and geographical distributions of this unique disease. Primary nasopharynx epithelial cells show very low EBV infection efficiency. A pertinent question in the etiology of NPC would be how and when EBV enters the host cell in NPC patients. Studies on the mouse gamma herpesvirus 68 suggest there is a temporal relationship between the period in life that infection occurs and the subsequent disease that develops. Infection occurring during the neonatal period of the mouse results in respiratory epithelial infection, whereas infection in the adult mouse results in an “infectious mononucleosis” like syndrome (1). Similarly, in humans, EBV infection appear to occur early in life in the susceptible populations for NPC (Southern China, Southeast Asia); whereas in populations with low incidence of NPC (such as in Caucasians), EBV infections occur later in the teens. Incidentally however, this later onset of EBV infection appears to be associated with a higher incidence and a bimodal peak of EBV-related Hodgkin’s Lymphoma in these populations. Of further note, in cities like Hong Kong and Singapore, where the incidence of NPC has been in decline in the last few decades, the incidence of Hodgkin’s Lymphoma in those 2 cities is slowly picking up and beginning to mimic the bimodal peak found in the Caucasian countries (2). Other infection-related cancers like Hepatitis B-associated hepatocellular carcinoma (HCC), H. pylori related gastric carcinoma (GC) and even Merkel cell polyomavirus related Merkel Cell Carcinomas have in common either perinatal, neonatal or early infections. We put forward that a similar mechanism may be at play here, and suggest a postulated mechanism for how EBV might enter the epithelial cell during the neonatal period, giving rise to a chain of events that ultimately results in the carcinogenesis of NPC. Periods of severe aridity between 135,000 and 75,000 years ago in East Africa are believed to be the impetus for human migration out of Africa (3). By about 50,000 to 40,000 years before present (ybp), some were thought to have arrived in Central Asia and settled there. Changes in climatic conditions with the glacial maximum made life difficult again and caused further dispersal. To the east were the insurmountable Pamir and Himalayan mountain ranges, so this forced those who moved east to skirt along the foothills of the Himalayas (in the narrow corridor of present-day Nepal), as they migrated in search of more hospitable environments (Figure 1). But these foothills were also holo-endemic for malaria (right until the time of the British, when they eliminated malaria) (4). This mal","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45929202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miRNA biomarkers for NPC diagnosis and prognosis","authors":"Mackenzie Fijardo, P. Bissey, K. Yip, Fei-Fei Liu","doi":"10.21037/anpc-21-4","DOIUrl":"https://doi.org/10.21037/anpc-21-4","url":null,"abstract":"MicroRNAs (miRNAs) are short non-coding RNAs that have been termed “master regulators of the genome” given their significance in post-transcriptional gene regulation, and roles in a multitude of normal and disease processes. In cancer, dysregulation of miRNAs can facilitate disease progression and therapeutic resistance, affecting tumour-suppressors and oncogenes. Nasopharyngeal carcinoma (NPC) is a unique head and neck cancer that is frequently associated with the Epstein-Barr virus (EBV). Advances in miRNA profiling techniques have highlighted the significance of both EBVand human genome-encoded miRNAs in the pathogenesis of NPC. These miRNAs have been implicated in critical NPC processes such as epithelial-to-mesenchymal transition (EMT) and metastasis, while further promoting chemoresistance and radioresistance. MiRNA signatures derived from profiling data and bioinformatics/statistical analyses may be particularly useful for the diagnosis of NPC, as well as the stratification of patients into clinically relevant groups to guide treatment selection. The identification and characterization of biologically relevant biomarkers will be crucial to improving patient outcomes and achieving greater understanding of the molecular underpinnings of NPC. This review integrates the literature on EBV-miRNAs, cellular miRNAs, and miRNA signatures to guide future research, while acknowledging challenges in the selection and clinical implementation of relevant miRNA biomarkers and signatures.","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41463370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision radiotherapy in nasopharyngeal carcinoma","authors":"W. Ng, S. Huang, H. Mai","doi":"10.21037/ANPC-21-3","DOIUrl":"https://doi.org/10.21037/ANPC-21-3","url":null,"abstract":"Radiotherapy plays a pivotal role in the treatment of nasopharyngeal carcinoma (NPC) and is the only realistic curative local treatment, usually combined with chemotherapy. Due to the very close proximity of adjacent critical organs at risk, the highest precision radiotherapy is mandated to eradicate cancer while minimizing treatment-induced toxicities. In this focused issue on “precision radiotherapy in NPC,” seven specific areas were addressed. The current standard of care in precision radiotherapy for NPC is intensity-modulated radiotherapy (IMRT). Optimization of IMRT plans can be a time-consuming process. With conventional planning algorithms, a standard IMRT plan for NPC takes hours to complete even by a highly experienced planner. Multiple trial-and-error and parameter tuning are traditionally needed during the plan optimization process. A more efficient plan optimization strategy is needed. Knowledge-based treatment planning relies on a data library built upon prior treatments and a planner-independent optimization algorithm. It has potential to streamline the process and speed up planning procedures. Many vendors are now offering such features, with promising preliminary applications, as summarized by Fung et al. Furthermore, the rapidly evolving field of artificial intelligence (AI) has begun to revolutionize the whole workflow in radiotherapy planning completely. In the article by Sun et al., automation from target delineation and treatment optimization to outcome prediction by AI are discussed. Consequently, a fully automated system in the future is expected to greatly facilitate the application of adaptive radiotherapy (ART) on a daily basis. As for the treatment delivery, Li et al. discuss the evolving roles of ART in NPC. This is an appealing strategy given the inevitable anatomical changes in tumor and organs-at-risk during the 6–7 weeks course of radiotherapy. However, the optimal workflow and when/how to trigger ART need to be carefully assessed, given its very labor-intensive property. Another area demanding precision radiotherapy is re-irradiation for locally recurrent NPC. Safe delivery of tumorocidal dose to recurrent tumor while protecting critical organs remains a major challenge. Stereotactic radiotherapy and proton therapy have an evolving role in selected cases, but high quality data are needed, preferably tested in clinical trials. The article by Huang et al. summarizes the role of stereotactic radiotherapy in salvaging small local tumor recurrence. In the article by Lee et al., the fundamental concept and beam properties of photon/heavy-ion particles are described; they also review the pros and cons of this rapidly evolving treatment method in locally recurrent NPC based on the clinical outcomes reported in the literature. Multimodality therapy is still the primary treatment approach for most patients with loco-regional advanced NPC, and there has been a major leap forward in the fields of both systemic and personaliz","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41952537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Epstein-Barr virus DNA analysis for personalised management of nasopharyngeal carcinoma—current opportunities and challenges","authors":"W. Lam, Yuk Ming Dennis Lo","doi":"10.21037/anpc-21-11","DOIUrl":"https://doi.org/10.21037/anpc-21-11","url":null,"abstract":"Plasma Epstein-Barr virus (EBV) DNA is a well-established tumour biomarker of nasopharyngeal carcinoma (NPC). There is ample evidence to support the clinical utility of plasma EBV DNA analysis for screening, prognostication and monitoring of recurrence of NPC. To fully realise its potential, researchers have been actively exploring the utility for guidance of personalised NPC treatment. There are ongoing studies to define high-risk group based on plasma EBV DNA results for subsequent escalation of treatment and the clinical outcome including survival would then be evaluated. In this review, we would summarise the current clinical indications of plasma EBV DNA analysis for NPC management. In particular, we would discuss the potentials and current challenges of using plasma EBV DNA to guide treatment for NPC. In addition, the molecular characteristics of plasma EBV DNA (quantitative, size and methylation profiles) from NPC samples have been recently revealed. In screening, some subjects harbour EBV DNA in plasma but do not have NPC. There are distinct molecular profiles of plasma EBV DNA between NPC and nonNPC subjects. Such knowledge has formed the basis of newer generation of plasma EBV DNA-based test, compared to conventional polymerase chain reaction-based assay, with enhanced diagnostic performance for the purpose of screening.","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44825498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic radiation therapy for recurrent nasopharyngeal carcinoma","authors":"Yu-Jie Huang, F. Fang, Hui‐Chun Chen, H. Hsu","doi":"10.21037/anpc-21-2","DOIUrl":"https://doi.org/10.21037/anpc-21-2","url":null,"abstract":": Radiation therapy is the mainstay treatment modality for nasopharyngeal carcinoma. Recurrent disease affects about 10% of patients, and reirradiation is the most common treatment for recurrent nasopharyngeal carcinoma. Serious complications are not uncommon during the second course of radiation therapy because of the full-tolerance radiation dose applied to normal tissue. Catastrophic toxicity may be induced by treatment for recurrent nasopharyngeal tumor. Salvage surgery has a 3-year overall survival of 85.8% with a 5% incidence of late fatal toxicity. However, the surgical approach is still relatively new with limited information and experience regarding its optimal implementation. Another technique used for recurrent nasopharyngeal carcinoma is stereotactic radiation therapy (SRT), which delivers radiation to a specific target with a rapid dose fall-off to adjacent normal tissue that can reduce the risk of complications. Single-shot radiation therapy for nasopharyngeal carcinoma has a local control rate of up to 72% for 2 years, although there is a 10% chance of cranial neuropathy and temporal lobe necrosis. Conventional fractionated SRT has shown a 3-year control rate of 56% with complications of 11% nasopharyngeal necrosis and 8.3% nasal bleeding. Hypofractionation SRT with a large fraction dose has demonstrated a 5-year control rate of 78% with a 12.5% to 16% incidence of fatal complications. Local recurrent nasopharyngeal carcinoma with a limited volume should be treated with SRT. For reirradiation, the dose constraints in organs at risk (OARs) of recurrent nasopharyngeal carcinoma are critical. Despite the lack of data regarding SRT, the radiation doses of OARs in SRT may be converted to a biologically equivalent dose and summed with doses of primary radiation therapy for evaluation. Hypofractionation may have an optimal treatment response rate with acceptable complications. For recurrent nasopharyngeal carcinoma, SRT has shown certain therapeutic advantages, but conventional fractionation radiation therapy may still be the appropriate setting for reirradiation. Patients undergoing SRT should be counseled carefully before initiation of therapy, especially if the targets are close to a critical organ that may cause serious side effects. The treatment decision of recurrent nasopharyngeal carcinoma should be based on the patient’s overall condition and disease status.","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48470362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CpG methylation as epigenetic biomarkers for nasopharyngeal carcinoma diagnostics","authors":"Lili Li, Jianlian Xie, B. Ma, A. Chan, Q. Tao","doi":"10.21037/anpc-21-9","DOIUrl":"https://doi.org/10.21037/anpc-21-9","url":null,"abstract":"","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45230107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}