CSCO and ASCO guideline: chemotherapy in combination with radiotherapy for definitive-intent treatment of stage II to IVA nasopharyngeal carcinoma
The joint Chinese and American guideline on when to add chemotherapy to radiotherapy for nasopharyngeal cancer: concurrent cisplatin for most stage II to IVA disease, induction gemcitabine-cisplatin for higher-risk disease, and how to handle patients who cannot take cisplatin.
Overview
Evidence-based guideline from the Chinese Society of Clinical Oncology and the American Society of Clinical Oncology based on a systematic review of randomised trials in stage II to IVA nasopharyngeal carcinoma, recommending concurrent cisplatin chemoradiotherapy, induction chemotherapy (gemcitabine-cisplatin preferred) for stage III to IVA disease with high-risk features, adjuvant chemotherapy in selected patients, and alternatives for cisplatin-ineligible patients, with cumulative cisplatin dose targets.
The standard-of-care rows on the locoregionally advanced nasopharyngeal page follow this guideline.
- Predates trials adding PD-1 antibodies to chemoradiotherapy and metronomic capecitabine adjuvant therapy.
- Most evidence comes from endemic regions.
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