Article record

鼻咽癌国际/国家管理指南的系统综述：推荐意见的趋同与分歧

A systematic review of international/national guidelines for the management of nasopharyngeal carcinoma: Convergence and divergence of recommendations.

指南共识鼻咽癌IF 6.6Q1

文献信息

PMID	42726913
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Qin Liu 查看其他 16 位作者 Handoko；Ji-Shi Li；Qiao-Juan Guo；Fernando Lopez；Primož Strojan；James C H Chow；Orlando Guntinas-Lichius；Karthik N Rao；Sweet Ping Ng；Sandra Nuyts；Wai-Tong Ng；Nabil F Saba；Carlos Chiesa-Estomba；M P Sreeram；Alfio Ferlito；Anne W M Lee
作者单位	Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China. 查看其他 19 条单位信息 Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors, Fujian Medical University, Fuzhou, China.；Digestive, Hematological, and Breast Malignancies, Clinical Research Center for Radiology and Radiotherapy of Fujian Province, Fuzhou, China.；Department of Clinical Oncology, University of Hong Kong, Hong Kong Special Administrative Region, China.；Department of Radiation Oncology Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Depok, Indonesia.；Clinical Oncology Center, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.；Clinical Oncology, School of Fujian Medical University Fujian Cancer Hospital, Fujian Medical University, Fuzhou, Fujian, China.；Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, Centro de Investigación en Red Cáncer Proyectos, Oviedo, Spain.；Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.；Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, China.；Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.；Department of Head and Neck Surgical Oncology, Sri Shankara Cancer Hospital and Research Center, Bangalore, India.；Department of Radiation Oncology, Austin Health, Melbourne, Heidelberg, Victoria, Australia.；Laboratory of Experimental Radiotherapy, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium.；Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.；Department of Hematology and Medical Oncology, The Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.；Department of Otolaryngology-Head and Neck Surgery, Donostia University Hospital, San Sebastian, Spain.；Faculty of Medicine, Deusto University, Bilbao, Spain.；Department of Head and Neck Surgery, Sri Shankara Cancer Hospital and Research Centre, Bangalore, India.；International Head and Neck Scientific Group, Padua, Italy.
期刊	Cancer
SCI 分区	Q1
IF	6.6
研究类型	指南共识 · 临床
所属专科	鼻咽癌

中文摘要

越来越多的国际/国家组织发布了鼻咽癌（NPC）临床实践指南，为临床医生在治疗方面做出循证决策提供了宝贵参考。然而，各种推荐意见存在显著差异，导致在选择最优策略时存在不确定性。作者系统检索了数据库和组织网站，查找2000年1月至2025年11月期间发布的NPC指南。所有识别出的指南均进行了质量评价；最终共纳入26部被评定为推荐使用的临床实践指南。对涵盖所有管理方面（诊断、分期、放疗、全身治疗、随访监测、生物标志物以及复发/转移性疾病的挽救治疗）的推荐意见进行了总结，并对其一致性和差异进行了比较分析。对于诊断检查、分期系统以及晚期疾病的诱导化疗联合同步放化疗存在强烈共识，而在放疗细节方面存在显著差异，尤其是靶区勾画、选择性照射范围和剂量规定。尽管不同分期组的全身治疗策略大多一致，但在替代方案和治疗细节方面存在显著差异。这是首个对国际NPC指南进行的全面系统综合，为临床医生了解所有推荐意见并根据当地资源和专业知识选择最优方案提供了实用参考，同时指出了当前需要未来研究以进一步标准化和协调统一的争议点。

英文摘要

Increasing numbers of clinical practice guidelines have been published by international/national groups for nasopharyngeal carcinoma (NPC), providing valuable references for clinicians in making evidence-based decisions on treatment. However, there are substantial discrepancies in various recommendations, leading to uncertainties in choosing the optimal strategies. The authors systematically searched databases and organizational websites for NPC guidelines published between January 2000 and November 2025. All identified guidelines underwent quality appraisal; in total, 26 clinical practice guidelines rated recommended for use were included. The recommendations covering all management aspects (diagnosis, staging, radiotherapy, systemic therapy, follow-up surveillance, biomarkers, and salvage of recurrent/metastatic diseases) were summarized and comparatively analyzed for consistency and disparities. Strong consensus exists for diagnostic workup, staging systems, and induction chemotherapy plus concurrent chemoradiotherapy for advanced disease, whereas marked disparities exist on radiotherapy details, particularly target volume delineation, elective coverage extent, and dose specifications. Although systemic therapy strategies for different stage groups were mostly consistent, substantial disparities exist in alternative options and treatment details. This first comprehensive systematic synthesis of international NPC guidelines provides a practical reference for clinicians to understand all recommendations and select optimal options based on local resources and expertise while identifying current controversies that demand future research for further standardization and harmonization.