Velindre Cancer Centre, Cardiff, UK.
Clin Oncol (R Coll Radiol). 2010 Sep;22(7):538-46. doi: 10.1016/j.clon.2010.05.024. Epub 2010 Jun 26.
Human papillomavirus (HPV) is associated with the development of a subset of head and neck cancers arising in the oropharynx, which includes the tonsils, base of tongue and soft palate. HPV-associated oropharyngeal cancer (OPC) seems to be rapidly increasing in incidence in many countries, including the USA, Sweden and Greece, and is known to affect younger patients who are less likely to have been exposed to the carcinogenic effects of tobacco and alcohol than their HPV-negative counterparts. There is accumulating evidence from prospective studies that HPV-positive OPC responds better to treatment, including chemotherapy and radiotherapy, than HPV-negative OPC, and that patients with HPV-positive disease have excellent long-term survival rates. To date, patients with HPV-positive and HPV-negative OPC are managed according to common treatment protocols; this may no longer be appropriate in an age when the delivery of targeted treatment, tailored to individual tumour and patient characteristics, is becoming a reality. This review summarises our current understanding of HPV-positive OPC, drawing parallels from the role of HPV in the development of cervical cancer. We also consider how knowledge of tumour HPV status may affect the future management and prevention of OPC and discuss the need for future collaborative trials in this important group of patients.
人乳头瘤病毒（HPV）与口咽癌（包括扁桃体、舌根和软腭）的发生有关。HPV 相关的口咽癌（OPC）在包括美国、瑞典和希腊在内的许多国家的发病率似乎正在迅速上升，并且已知会影响到不太可能接触烟草和酒精致癌作用的年轻患者，而这些年轻患者与 HPV 阴性的患者相比。前瞻性研究的证据不断积累，表明 HPV 阳性 OPC 对治疗（包括化疗和放疗）的反应优于 HPV 阴性 OPC，并且 HPV 阳性疾病患者的长期生存率极佳。迄今为止，HPV 阳性和 HPV 阴性 OPC 患者的治疗依据是共同的治疗方案；当针对个体肿瘤和患者特征的靶向治疗成为现实时，这种治疗方法可能不再合适。这篇综述总结了我们目前对 HPV 阳性 OPC 的理解，从 HPV 在宫颈癌发展中的作用中得出了一些相似之处。我们还考虑了肿瘤 HPV 状态的知识如何影响 OPC 的未来管理和预防，并讨论了在这一重要患者群体中进行未来合作试验的必要性。
