Furuta Mitsuhiro, Yokota Tomoya
Division of Gastrointestinal Oncology, Shizuoka Cancer Center.
Gan To Kagaku Ryoho. 2018 Mar;45(3):419-423.
Concurrent cisplatin based chemoradiotherapy(CRT)is the standard of care for patients with locoregionally advanced squamous cell carcinoma of the head and neck(LA-SCCHN). Based on the Bonner trial showing the superiority of cetuximab plus radiotherapy to radiotherapy alone, cetuximab based bioradiotherapy(BRT)is considered as an alternative for patients with LA-SCCHN. However, the non-inferiority of BRT compared to CRT has not yet been demonstrated. Furthermore, severe mucositis and dermatitis induced by BRT cannot be neglected. Therefore, the patient's general status and comorbidity should be considered before BRT. Supportive care and patient education are also necessary to safely complete the treatment. Several phase III trials are ongoing to evaluate BRT and CRT for human papillomavirus(HPV)positive oropharyngeal carcinoma. Novel biomarkers are needed for identifying patients most likely to benefit from BRT.
基于顺铂的同步放化疗（CRT）是局部晚期头颈部鳞状细胞癌（LA-SCCHN）患者的标准治疗方案。基于Bonner试验显示西妥昔单抗联合放疗优于单纯放疗，基于西妥昔单抗的生物放疗（BRT）被认为是LA-SCCHN患者的一种替代方案。然而，BRT与CRT相比的非劣效性尚未得到证实。此外，BRT引起的严重粘膜炎和皮炎不容忽视。因此，在进行BRT之前应考虑患者的一般状况和合并症。支持性护理和患者教育对于安全完成治疗也很有必要。目前正在进行几项III期试验，以评估BRT和CRT用于人乳头瘤病毒（HPV）阳性口咽癌的疗效。需要新的生物标志物来识别最有可能从BRT中获益的患者。
