Abstract
Adolescent and childhood nasopharyngeal carcinoma (NPC) is a rare malignancy with unique biological and genetic characteristics, often associated with Epstein-Barr virus (EBV). This CACA guideline provides an integrative approach to the management of adolescent and childhood NPC, focusing on biology, diagnosis, staging, and treatment strategies. The incidence of NPC is higher in adolescent boys and is more frequently diagnosed at an advanced stage in adolescent and childhood population compared to adults. However, adolescent and childhood NPC generally have a better prognosis. The primary treatment is radiotherapy (RT), with intensity-modulated radiation therapy (IMRT) being the preferred technique due to its reduced damage to normal tissues. Chemotherapy, particularly induction chemotherapy, plays a significant role, especially in locally advanced disease. Personalized treatment strategies, including adjusting RT dosage based on chemotherapy outcomes, may reduce long-term adverse effects. The role of adjuvant therapy post-RT remains unclear and requires further research. The main objective of this guideline is to standardize the clinical diagnosis and treatment process of adolescent and childhood nasopharyngeal carcinoma, with a multidisciplinary approach to optimize therapeutic outcomes and quality of life for this disease.
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1 Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People’s Republic of China (GRID:grid.12981.33) (ISNI:0000 0001 2360 039X)
2 National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology, Beijing, People’s Republic of China (GRID:grid.506261.6) (ISNI:0000 0001 0706 7839)
3 Chongqing University Cancer Hospital, Radiation Oncology Center, Chongqing, People’s Republic of China (GRID:grid.190737.b) (ISNI:0000 0001 0154 0904)
4 Fudan University, Department of Radiation Ocology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Shanghai, People’s Republic of China (GRID:grid.8547.e) (ISNI:0000 0001 0125 2443)
5 The First Affiliated Hospital of Guangxi Medical University, Department of Radiation Oncology, Nanning, People’s Republic of China (GRID:grid.412594.f)
6 Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Department of Radiation Oncology, Hangzhou, People’s Republic of China (GRID:grid.417397.f) (ISNI:0000 0004 1808 0985)
7 The University of Hong Kong-Shenzhen Hospital, Department of Clinical Oncology, Shenzhen, People’s Republic of China (GRID:grid.440671.0) (ISNI:0000 0004 5373 5131)