Bozec A, Thariat J, Bensadoun R J, Milano G
Département de Chirurgie, Institut Universitaire de la Face et Du Cou, Centre Antoine-Lacassagne, 33, avenue de Valombrose, Nice, France.
Cancer Radiother. 2008 Jan;12(1):14-24. doi: 10.1016/j.canrad.2007.11.003. Epub 2008 Jan 9.
Radiotherapy is an essential treatment for many patients with head and neck squamous cell carcinoma. Its association with molecular targeted therapies represents a real progress. Among the recent advances in the molecular targeted therapy of cancer, the applications centred on EGFR are currently the most promising and the most advanced at clinical level. Considering the set of therapeutic tools targeting EGFR, there are at present two well-identified emerging categories of drugs with monoclonal antibodies, on the one hand, and tyrosine kinase inhibitors, on the other. In many preclinical studies, the combination of anti-EGFR drugs with irradiation has led to additive or supra-additive cytotoxic effects. Furthermore, antiangiogenic agents have shown promising results in association with anti-EGFR drugs and radiotherapy. This research effort has recently produced encouraging clinical results in advanced head and neck cancer with combination of cetuximab (an anti-EGFR monoclonal antibody) with irradiation with a significant impact on patient survival. Active and efficient clinical research is currently ongoing to determine the place of molecular targeted therapies in the treatment of head and neck cancer, particularly in association with radiotherapy.
放射治疗是许多头颈部鳞状细胞癌患者的重要治疗方法。它与分子靶向治疗相结合代表了一项真正的进展。在癌症分子靶向治疗的最新进展中,以表皮生长因子受体(EGFR)为中心的应用目前在临床层面最具前景且最为先进。考虑到针对EGFR的一系列治疗工具,目前有两类明确出现的药物,一类是单克隆抗体药物,另一类是酪氨酸激酶抑制剂。在许多临床前研究中,抗EGFR药物与放疗联合使用已产生相加或超相加的细胞毒性作用。此外,抗血管生成药物与抗EGFR药物及放疗联合使用已显示出有前景的结果。最近,西妥昔单抗(一种抗EGFR单克隆抗体)与放疗联合用于晚期头颈部癌的研究取得了令人鼓舞的临床结果,对患者生存率有显著影响。目前正在进行积极且有效的临床研究,以确定分子靶向治疗在头颈部癌治疗中的地位,特别是与放疗联合使用时的地位。