文章：

放疗与全身性治疗：聚焦头颈癌

Radiotherapy and Systemic Therapies: Focus on Head and Neck Cancer

原文发布日期：24 August 2023

DOI: 10.3390/cancers15174232

类型: Article

开放获取: 是

英文摘要：

Head and neck squamous cell carcinoma (HNSCC) is a complex clinical entity, and its treatment strategy remains a challenge. The best practice management for individual HNSCC patients should be discussed within a multidisciplinary team. In the locally advanced disease, radiation therapy (RT) with or without concomitant cisplatin-based chemotherapy is the current standard of care for most patients treated definitively or adjuvantly after surgery. Intensity-modulated photon therapy (IMRT) is the recommended RT technique due to its ability to offer considerable treatment conformality while sparing surrounding normal critical tissues. At present, the development of novel treatment strategies, as well as alternative systemic agent combinations, is an urgent need to improve the therapeutic ratio in HNSCC patients. Despite the immune landscape suggesting a strong rationale for the use of immunotherapy agents in HNSCC, evidence-based data demonstrate that combining RT with immune checkpoint inhibitors as the primary treatment modality has not been shown to induce significant benefit on survival clinical outcomes. The objective of this article is to review the current literature on the treatment of patients with HNSCC. We initially provided a comprehensive overview of the standard of care. We then focused on the integration of systemic therapies with RT, highlighting the latest published evidence and ongoing trials which investigate different combination strategies in the definitive setting. Our hope is to summarize relevant literature in order to provide a foundation for interpreting emerging data and designing future trials to maximize care, both in disease control and patient quality of life.

摘要翻译： 

头颈部鳞状细胞癌（HNSCC）是一种复杂的临床疾病，其治疗策略仍面临挑战。针对个体HNSCC患者的最佳治疗方案应在多学科团队中进行讨论。对于局部晚期疾病，放疗联合或不联合以顺铂为基础的化疗是目前大多数患者根治性或术后辅助治疗的标准方案。调强光子放疗因其能在保证治疗适形性的同时保护周围正常关键组织，成为推荐的放疗技术。当前，亟需开发新的治疗策略及替代性全身药物组合，以提高HNSCC患者的治疗获益比。尽管免疫微环境特征为HNSCC应用免疫治疗提供了理论依据，但循证数据表明，将放疗与免疫检查点抑制剂联合作为主要治疗手段，尚未显示出对生存临床结局的显著改善。本文旨在综述当前关于HNSCC患者治疗的文献。我们首先全面概述了标准治疗方案，随后重点探讨全身治疗与放疗的整合策略，着重分析已发表的最新证据及正在进行的临床试验，这些研究探索了根治性治疗中不同联合治疗策略的效果。希望通过总结相关文献，为解读新兴数据和设计未来临床试验提供基础，从而在疾病控制与患者生活质量两方面实现治疗最优化。

原文链接：

Radiotherapy and Systemic Therapies: Focus on Head and Neck Cancer