Cojocariu O M, Huguet F, Lefevre M, Périé S
Service d'oncologie-radiothérapie, hôpital Tenon, Assistance publique des Hôpitaux de Paris, Cancerest, GHU Est, université Paris-VI, Paris, France.
Bull Cancer. 2009 Apr;96(4):369-78. doi: 10.1684/bdc.2009.0777.
The head-and-neck squamous-cell carcinomas (HNSCC) represent in order of frequency the fourth leading cause of cancer deaths among men in France. The term HNSCC includes various anatomopathological and clinical entities with different evolution patterns. For this reason, it is necessary to identify prognostic and predictive factors able to help in the choice of the treatment. The clinical factors with a prognostic value are the tumor location, the tumor size and the lymph node status. The degree of differentiation is the most important histologic factor. More recently, the identification of molecular factors has opened the way to new therapies. Thus, the overexpression of EGFR is associated with a poor prognosis. Its inhibition improves the survival of patients. p53 mutations and cyclin D1 amplification are actually subject to intensive research. The tumors associated with HPV infection are distinguishable by a better prognosis. 18-alpha-FDG positron emission tomography emerges as a useful tool for the therapeutic evaluation. The evolution of surgical techniques, the development of induction chemotherapy regimen or concurrent ones with radiotherapy and new techniques of conformal irradiation also results in a better locoregional control.
头颈部鳞状细胞癌（HNSCC）是法国男性中按发病频率排列的第四大致癌死亡原因。HNSCC一词包括具有不同演变模式的各种解剖病理学和临床实体。因此，有必要确定能够帮助选择治疗方法的预后和预测因素。具有预后价值的临床因素包括肿瘤位置、肿瘤大小和淋巴结状态。分化程度是最重要的组织学因素。最近，分子因素的鉴定为新疗法开辟了道路。因此，表皮生长因子受体（EGFR）的过表达与预后不良相关。对其进行抑制可提高患者的生存率。p53突变和细胞周期蛋白D1扩增目前正受到深入研究。与人类乳头瘤病毒（HPV）感染相关的肿瘤预后较好。18-α-氟脱氧葡萄糖（18-α-FDG）正电子发射断层扫描成为治疗评估的有用工具。手术技术的发展、诱导化疗方案或与放疗同时进行的化疗方案的开发以及适形放疗新技术也带来了更好的局部区域控制。
