Nasopharyngeal cancer, the stable effect brought by the combination of radiotherapy and immunotherapy

时间：2026-04-22　人气：

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Overview of the disease

This is Mr. Zhao's third disease evaluation. Previous evaluations are available at by clicking the link below .

First evaluation (April 8, 2022): After 33 rounds of radiotherapy, I am still worried about metastasis and recurrence.
Second evaluation (December 2, 2022): As a nasopharyngeal cancer patient who underwent 33 rounds of radiotherapy and 4 rounds of chemotherapy, the latest evaluation results are now available.

Third evaluation: Mr. Zhao underwent nasopharyngoscopy in January 2020, and a suspected diagnosis of nasopharyngeal cancer was made. PET-CT examination showed consistent findings of nasopharyngeal cancer with metastasis to the right parapharyngeal space and cervical lymph nodes. After confirmation through imaging and pathological biopsy, nasopharyngoscopy and pathological diagnosis revealed (right nasopharynx) non-keratinizing squamous cell carcinoma "undifferentiated type". Immunohistochemistry showed CKAE1/AE3+; CK5/6+; P40+; VEGFR1(++)S accounting for 80%; VEGFR2(+)S accounting for 30%; VEGFR3(+)S accounting for 1%; PD-1 tumor cells and stromal immune cells were both (-); PD-LI tumor cells (+)S accounting for 70%, and stromal immune cells (+)S accounting for 10%; MLH-1(+++)S accounts for 70%; MLH-2(++)S accounts for 80%; MLH-6(+++)S accounts for 90%; PMS-2:(++)S accounts for 70%; ki-67(+)S accounts for 70%. ).”.

Unlike most tumors, nasopharyngeal cancer is typically treated with radiotherapy rather than surgery due to its specific location and relative sensitivity to radiation therapy. Mr. Zhao, following his doctor's advice, opted for chemotherapy combined with radiotherapy instead of surgery. Chemotherapy is a systemic treatment that can cause significant harm to the body. After undergoing two courses of chemotherapy in February 2020, Mr. Zhao commenced a regimen of radiotherapy combined with chemotherapy. By April 2020, he had undergone a total of 33 radiotherapy sessions and two chemotherapy sessions.

Section

Small

Knowledge

Recognition

Causal Factors of Nasopharyngeal Carcinoma

Human Herpesvirus (EBV): Just as hepatitis viruses can lead to liver cancer, EBV is also a significant contributor to nasopharyngeal carcinoma. Studies have shown the presence and expression of viral genomes in the cancerous tissues of nearly all nasopharyngeal carcinoma patients. However, viral infection does not necessarily guarantee the development of nasopharyngeal carcinoma in the future. In most cases, EBV can coexist peacefully with humans, only proliferating wildly and inducing the lysis of infected epithelial cells under certain specific conditions, such as immune deficiency.

Chemical Factors: Nitrosamines and their compounds are closely associated with the development of nasopharyngeal carcinoma. Consuming foods such as salted fish, cured meat, and pickled vegetables, which are high in nitrites, can lead to the occurrence of nasopharyngeal mucosal lesions. Studies have also found that excessive intake of the trace element nickel and insufficient intake of selenium may also promote the development of nasopharyngeal carcinoma. The content of nickel in soil, water, and rice in high-incidence areas of Guangdong is higher than in other regions.

Genetic Factors: Clinical data indicate that nasopharyngeal carcinoma has racial and familial predispositions, suggesting that genetic factors may play a significant role in its occurrence. Geneticists' research has shown the presence of susceptibility genes for nasopharyngeal carcinoma on chromosome 4, confirming that nasopharyngeal carcinoma can be inherited and transmitted to future generations.

Despite undergoing radiotherapy and chemotherapy for the lesion, there is still a risk of tumor recurrence and metastasis without additional intervention. After completing traditional treatment, Mr. Zhao and his family sought the help of Professor Zhang Minghui's team at Tsinghua University School of Medicine. After learning about the demonstrated cases of vNKT cell therapy, they hope to reduce the risk of future metastasis and recurrence.

After reviewing Mr. Zhao's medical records, Professor Zhang Minghui made the following analysis and judgment:

1. The patient has completed conventional radiotherapy, but there is still a risk of metastatic recurrence. Some undetected tumor cells may metastasize through blood vessels and lymphatic vessels, which are difficult to detect in the early stage.

2. Nasopharyngeal cancer often metastasizes to cervical lymph nodes through lymphatic vessels and to lungs and bones through blood vessels. vNKT cell therapy has a strong protective effect on lymph nodes and organs with rich blood supply.

3. vNKT therapy utilizes powerful immune cells to eliminate tumor cells that may remain undetected in the body, with essentially no side effects, making it very patient-friendly. After completing radical radiotherapy, combining it with vNKT cells can effectively reduce the risk of metastatic recurrence.

Mr. Zhao underwent vNKT cell immunotherapy in June 2020 and has completed 20 courses so far (as of March 2023). Multiple follow-up examinations have shown no obvious signs of tumor progression, and the overall evaluation is stable!

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Tumor markers

Month

No abnormalities were found in tumor markers tested from August 2020 to April 2023. Please pay attention to follow-up examinations.

Conclusion and Comments

Mr. Zhao's quality of life has been significantly improved. His physical strength has noticeably improved compared to before treatment, and his mental state is excellent, returning to the state before he fell ill. He is able to work and live normally, and his disease has not been affected.

After undergoing vNKT cell therapy, Mr. Zhao achieved the expected results. Over the nearly two years of treatment, multiple assessments have shown stable disease, and the latest assessment still shows no progression.

In a statistical analysis of 206 treated patients with nasopharyngeal carcinoma, 26% of the patients only received conventional radiotherapy, 37% received neoadjuvant chemotherapy followed by conventional radiotherapy, and 29% received neoadjuvant chemotherapy + sequential chemotherapy + conventional radiotherapy. During a median follow-up of 29 months, 112 patients (54.4%) were alive without recurrence or metastasis, and the three-year disease-free survival rate and overall survival rate were 64% and 82.3%, respectively. In addition, the statistical analysis found that combined treatment for nasopharyngeal carcinoma can bring good results ^[1].

Nasopharyngeal carcinoma has the highest metastatic potential among all head and neck cancers, and multimodal combined treatment can achieve better results. In this process, vNKT cell immunotherapy plays an indispensable role in reducing the risk of recurrence and metastasis and strengthening the immune system, thereby providing patients with long-term stability.

References:

1Indian Journal of Cancer (IF 1.0) Pub Date : 2017-05-10 ,DOI:10.4103/0019-509x.204762S G Laskar,L Gurram,T Gupta,A Budrukkar,V Murthy,J P Agarwal.

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