International Journal of Clinical Research

Nasopharyngeal carcinoma (NPC) is a head and neck malignancy that is highly sensitive to radiotherapy, and its treatment strategy has made significant progress in recent years. Based on the data of 32 clinical studies (including 15 randomized controlled trials) at home and abroad from 2018 to 2023, this article systematically analyzes the differences in efficacy of different treatment modes. Intensity-modulated radiotherapy (IMRT) significantly improved the 5-year local control rate (92.1% vs. 80.4%, P<0.001) compared with conventional radiotherapy, while concurrent chemoradiotherapy (CCRT) increased the 3-year progression-free survival rate of patients with stage III-IVA to 84.5% (95% CI 81.2-87.8). In addition, the introduction of targeted and immunotherapy further improved the prognosis, such as the phase II trial (NCT03655613) of anti-PD-1 combined with CCRT, which showed an objective response rate of 96.3% and an increase in EBV DNA clearance of 41.2% (P=0.003). Optimization of comprehensive treatment strategies should be combined with individualized assessment. Multicenter data (*n*=2,156) confirmed that the Nomogram model based on plasma EBV DNA, T stage, and tumor volume accurately predicted 5-year overall survival (C-index = 0.82). Future research directions should focus on the optimization of the timing of immunotherapy, the screening of radiosensitive biomarkers, and the validation of phase III clinical trials in large samples to further improve the long-term survival benefits of nasopharyngeal carcinoma patients.

Nasopharyngeal carcinoma; Radiotherapy; Combined modality therapy; Immunotherapy; Precision medicine