2021 CSCO Guide Conference | Professor Tang Linglong: Interpretation of the highlights of nasopharyngeal cancer radiotherapy update

The 2021 Chinese Society of Clinical Oncology (CSCO) Guidelines Conference will be held in Beijing from April 23rd to 24th with a combination of online and offline methods.

Yimaitong invited Professor Tang Linglong from Sun Yat-sen University Cancer Center to share the highlights of the radiotherapy section of the 2021 CSCO Guidelines for Nasopharyngeal Carcinoma Diagnosis and Treatment.

Highlights of Radiotherapy for Nasopharyngeal Cancer Professor Tang Linglong: Radiotherapy is the most important treatment method for nasopharyngeal cancer.
In order to further standardize the radiotherapy process for nasopharyngeal cancer, and at the same time improve the homogeneity of radiotherapy across the country, the 2021 version of nasopharyngeal cancer The radiotherapy part of the diagnosis and treatment guidelines has been updated and revised in the following aspects: First, starting from every detail, the radiotherapy process is more detailed and standardized.

From the assessment of the patient's radiotherapy conditions before treatment, the preparation of CT positioning, to the formulation of radiotherapy plans, the verification and implementation of radiotherapy, to follow-up and follow-up, we provide patients with safe and standardized diagnosis and treatment services.

Second, on the basis of the 2020 version of the clinical target volume (CTV) delineation guidelines, the delineation principle of gross tumor volume (GTV) has been added.
For patients receiving induction chemotherapy, it is recommended to delineate GTV according to the range after induction chemotherapy.

However, for some special structures, such as bone or paranasal sinuses, it is still recommended to delineate GTV according to the scope before induction chemotherapy.

Third, a new limit standard for normal organizations has been added.

The 2020 version of the guidelines only stipulates how to delineate normal tissues, and the new version of the guidelines further stipulates the tolerable dose of normal tissues.

Fourth, with the development of information and the advancement of computer technology, in the field of radiotherapy, we recommend that qualified units can use artificial intelligence methods to assist in delineating the target area and normal organs.
While improving the processing efficiency, it also increases the distance between units.
Homogeneity.

Reduce the complications of radiotherapy and improve the quality of life Professor Tang Linglong: While radiation kills tumor cells, it also damages the surrounding normal tissue cells to a certain extent, so the side effects of radiotherapy for nasopharyngeal carcinoma are more obvious.

In recent years, with the continuous improvement of radiotherapy technology, the quality of life of patients has been greatly improved.

The most common side effects of radiotherapy include varying degrees of dry mouth, hearing loss, temporal lobe necrosis, dysphagia, etc.
In addition, dental caries and neck muscle stiffness may also occur.

Reducing the side effects of radiotherapy in patients is also an original intention of our guidelines.

First of all, it is necessary to ensure the standardization of radiotherapy.
China is vast, the economic level of various regions is different, and medical resources are also unbalanced, which leads to the inconsistent treatment of nasopharyngeal cancer patients in China.
The CSCO guidelines are of great significance for guiding clinicians to conduct standardized diagnosis and treatment.
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For example, in the new version of the guidelines for diagnosis and treatment of nasopharyngeal carcinoma, considering the imbalance of medical resources in various regions, the recommendation of three-dimensional intensity-modulated radiotherapy was deleted.
The expert group believes that qualified patients can be recommended to units that carry out intensity-modulated radiotherapy for treatment.
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Secondly, the delineation of the target area plays an important role in improving the curative effect of nasopharyngeal carcinoma and reducing toxic and side effects.

Accurately delineating tumor target areas and organs at risk can better optimize tumor radiotherapy plans, improve the dose distribution of tumor target areas, improve the efficacy of radiotherapy, and prolong the survival time of patients.

Moreover, it is beneficial to protect the surrounding important normal tissues, reduce the side effects of radiotherapy, and improve the quality of life of patients.