Liječenje nazofaringealnog karcinoma

master's thesis

• Title (english): Treatment of nasopharyngeal carcinoma
• Author: Maria Banović
• Mentor: Vesna Bišof (mentor)
• Committee member: Mario Bilić (predsjednik povjerenstva)
• Committee member: Mihael Ries (član povjerenstva)
• Committee member: Vesna Bišof (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Clinical Oncology); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Nazofaringealni karcinom (NPC) je maligna bolest koja se razvija u nazofarinsku i zbog svoje lokalizacije, ali i raznolike etiologije te nespecifične kliničke slike, predstavlja značajan izazov u dijagnostici i liječenju. Odluku o liječenju donosi multidisciplinarni tim. Danas postoji nekoliko terapijskih pristupa u liječenju nazofaringealnog karcinoma, a odabir terapije ovisi o stadiju bolesti, općem zdravstvenom stanju pacijenta i drugim čimbenicima. NPC je visokoosjetljiv na ionizirajuće zračenje pa radioterapija danas predstavlja glavni terapijski odabir u liječenju ranih stadija tumora s naglaskom na intenzitetno moduliranu radioterapiju (IMRT, engl. intensity-modulated radiotherapy) kod koje je dokazano bolje preživljenje, lokalna kontrola bolesti uz smanjeno toksično djelovanje na okolne strukture. Kada radioterapija sama postane nedostatna u liječenju uznapredovalih oblika karcinoma, pristupa se drugim terapijskim metodama pri čemu je najčešće riječ o kemoterapiji temeljenoj na cisplatini. Kemoterapija se kod lokoregionalno uznapredovale bolesti primjenjuje samostalno prije ili nakon konkomitantne kemoradioterapije. U slučaju lokalnog recidiva u pojedinih bolesnika dolazi u obzir i kirurško liječenje, brahiterapija ili sterotaksijska radioterapija. Metastatska bolest liječi se kemoterapijom. Nadalje, nazofaringealni karcinom pokazuje značajnu povezanost s Epstein- Barr virusom (EBV) što uvelike pridonosi razvoju novijih terapijskih modaliteta s naglaskom na imunoterapiji i molekularnoj terapiji.

Abstract (english)

Nasopharyngeal carcinoma (NPC) is a malignant disease that develops in the nasopharynx and, due to its localization, diverse etiology and non-specific clinical picture, represents a significant challenge in diagnosis and treatment. The decision on treatment is made by a multidisciplinary team. Today, there are several therapeutic approaches in the treatment of nasopharyngeal cancer, and the choice of therapy depends on the stage of the disease, the patient's general health and other factors. NPC is highly sensitive to ionizing radiation, so radiotherapy today represents the main therapeutic choice in the treatment of early tumor stages, with an emphasis on intensity-modulated radiotherapy (IMRT), which has proven better survival, and local control of the disease with reduced toxic effects on surrounding tissues structures. When radiotherapy alone becomes insufficient in the treatment of advanced forms of cancer, other therapeutic methods are used, the most common of which is cisplatin-based chemotherapy. In locoregionally advanced disease, chemotherapy is applied alone before or after concomitant chemoradiotherapy. In the case of local recurrence, surgical treatment, brachytherapy or sterotaxic radiotherapy can also be considered in some patients. Metastatic disease is treated with chemotherapy. Furthermore, nasopharyngeal carcinoma shows a significant association with the Epstein-Barr virus (EBV), which greatly contributes to the development of newer therapeutic modalities with an emphasis on immunotherapy and molecular therapy.

• Keywords: nazofaringealni karcinom; Epstein-Barr virus; radioterapija; IMRT; kemoterapija
• Keywords (english): nasopharyngeal cancer; Epstein-Barr virus; radiotherapy; IMRT; chemotherapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:202011
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-20 10:20:05