Treatment of Stage IB to III Nasopharyngeal Carcinoma: CSCO-ASCO Guideline Update.

For non-metastatic stage IB–III nasopharyngeal carcinoma, the updated CSCO-ASCO guideline strengthens definitive treatment with IMRT plus image guidance and MRI-based target delineation as core components.

• Why it matters: New evidence has emerged on radiotherapy planning, target-volume de-escalation, chemotherapy regimen sequencing, adjuvant strategies, and PD-1–based immunotherapy, creating a need to refresh recommendations since 2021.
• What they did: A multidisciplinary expert panel reviewed post-2021 randomized trials, systematic reviews, meta-analyses, and prospective/retrospective studies, focusing on survival, disease control, toxicities, and quality of life, then built recommendations via the ASCO guideline process and consensus.
• The result: The update endorses cisplatin-based concurrent chemoradiotherapy, GP or TPF preferred induction regimens, selected adjuvant chemotherapy including metronomic capecitabine for higher residual risk, and notes PD-1 trials improve disease control while overall survival data remain immature.

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