Coughlin A M, Qiu S, Underbrink M P
Department of Otolaryngology, Head and Neck Surgery, University of Texas Medical Branch, Galveston, Tex., USA.
Curr Probl Dermatol. 2014;45:236-51. doi: 10.1159/000356182. Epub 2014 Mar 13.
Human papillomavirus (HPV)-related head and neck malignancies (HNMs) have become a serious health risk over the past 20 years. Despite decreases in non-HPV-related HNMs, the incidence of HPV-related HNMs has skyrocketed, and a new form of tumorigenesis is developing. HPV type 16 is the primary offender, and the majority of these tumors present in the oropharynx, with a smaller proportion in the larynx and oral cavity. While traditionally treated with surgery, the paradigm has shifted to more of a nonoperative chemoradiation therapy approach, with the hope of improving vital functions after therapy. Unfortunately, we continue to see significant dysphagia in these patients after treatment, and work is being done to improve outcomes. With the advent of transoral robotic surgery, we have again been able to reconsider treatment options for these patients, although it has been met with some skepticism and resistance. Here we discuss the scope of HPV-related HNMs, the treatment options and prognosis for the disease, and finally touch upon psychosocial issues related to HPV-related HNMs.
在过去20年里，人乳头瘤病毒（HPV）相关的头颈部恶性肿瘤（HNMs）已成为严重的健康风险。尽管非HPV相关的HNMs发病率有所下降，但HPV相关的HNMs发病率却急剧上升，一种新的肿瘤发生形式正在形成。16型人乳头瘤病毒是主要致病因素，这些肿瘤大多发生在口咽，少数发生在喉和口腔。传统上采用手术治疗，但现在治疗模式已转向更多的非手术放化疗方法，以期改善治疗后的重要功能。不幸的是，我们在这些患者治疗后仍看到严重的吞咽困难，目前正在努力改善治疗结果。随着经口机器人手术的出现，我们再次能够重新考虑这些患者的治疗选择，尽管这一方法受到了一些质疑和抵制。在此，我们将讨论HPV相关HNMs的范围、该疾病的治疗选择和预后，最后探讨与HPV相关HNMs有关的社会心理问题。
