Yom Sue S, Ganti Apar K, Dietz Andreas
From the Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; Department of Head Medicine and Oral Health, University of Leipzig, Leipzig, Germany.
Am Soc Clin Oncol Educ Book. 2016;35:176-83. doi: 10.1200/EDBK_161309.
Scientific investigation is extremely active in the treatment, management, and optimization of therapies for patients with head and neck cancer. These issues have undergone recent rapid evolution in response to a changing epidemiology based on an increasing proportion of HPV-associated oropharyngeal cancer with advances in multimodality technologies to improve outcomes and reduce toxicity. Choices of definitive treatment of various anatomic subsites are being refined, balancing the relative indications and advantages of surgery or chemoradiation-based strategies. The major potential influence of HPV-associated etiology on therapy selection, prognostic factors, response to treatment, survival outcomes, and post-treatment surveillance has created a robust and distinct field of scientific inquiry around this patient subset. Meanwhile, for patient subsets where prognosis remains poor, therapeutic intensification is being explored, and for recurrent/metastatic disease, improved selection for salvage and novel systemic therapies are under development. For all patients with head and neck cancer, upholding principles of equity and access to the highly specialized care that results in optimal outcomes should be the goal.
在头颈癌患者的治疗、管理和治疗优化方面，科学研究极为活跃。鉴于HPV相关口咽癌比例不断增加，以及多模态技术取得进展以改善治疗效果并降低毒性，从而导致流行病学发生变化，这些问题最近经历了快速演变。各种解剖亚部位的确定性治疗选择正在不断完善，平衡手术或基于放化疗策略的相对适应症和优势。HPV相关病因对治疗选择、预后因素、治疗反应、生存结果以及治疗后监测的主要潜在影响，围绕这一患者亚群形成了一个强大且独特的科学研究领域。与此同时，对于预后仍然较差的患者亚群，正在探索强化治疗，对于复发/转移性疾病，正在开发改进的挽救治疗选择和新型全身治疗方法。对于所有头颈癌患者而言，秉持公平原则并确保他们能够获得能带来最佳治疗效果的高度专业化护理，应是目标所在。
