Tribius S, Würdemann N, Laban S, Sharma S J, Wagner S, Hoffmann T K, Wittekindt C, Klussmann J P
Asklepios Klinik St. Georg, Hermann-Holthusen-Institut für Strahlentherapie, Asklepios Tumorzentrum Hamburg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland.
Medizinische Fakultät, Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik zu Köln, 50937, Köln, Deutschland.
HNO. 2018 Dec;66(12):888-895. doi: 10.1007/s00106-018-0577-3.
Rising incidence rates in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) and a significantly improved prognosis have brought this entity into scientific focus. At this year's American Society of Clinical Oncology (ASCO) Annual Meeting, 291 studies with the keyword "HPV" were presented, the majority of which were in head and neck cancer. Due to high rates of late toxicities after conventional therapy, de-intensified treatment concepts are being increasingly discussed, although data from prospective phase III studies were not presented. Retrospective data on the latest TNM staging (downstaging in many HPV-associated patients) and other risk stratification systems were presented. HPV diagnostics based solely on p16 immunohistochemistry were discussed. Many groups presented work on the HPV association and its prognostic relevance not only in oropharyngeal carcinoma, but also in oral cavity, hypopharyngeal, and locally advanced laryngeal squamous cell carcinoma. New prognostic biomarkers such as methylation signatures appear to be promising. New data suggest equal survival rates in HPV-associated stage I OPSCC treated with surgery alone in comparison to patients who received adjuvant therapy after surgery. A possible negative effect on overall survival in stage III HPV-associated OPSCC with a cisplatin dose ≤200 mg/m was discussed. Results of de-escalation studies are urgently awaited, in order to be able to treat HPV-associated OPSCC patients as precisely and as specifically as possible and ensure long-term quality of life.
人乳头瘤病毒（HPV）相关的口咽鳞状细胞癌（OPSCC）发病率不断上升，且预后显著改善，这使得该疾病成为科学研究的焦点。在今年的美国临床肿瘤学会（ASCO）年会上，展示了291项关键词为“HPV”的研究，其中大部分是关于头颈癌的。由于传统治疗后晚期毒性发生率较高，尽管前瞻性III期研究的数据尚未公布，但强度降低的治疗概念仍在越来越多地被讨论。会上展示了关于最新TNM分期（许多HPV相关患者分期降低）和其他风险分层系统的回顾性数据。讨论了仅基于p16免疫组化的HPV诊断方法。许多研究团队不仅展示了关于HPV相关性及其在口咽癌中的预后相关性的研究成果，还包括在口腔癌、下咽癌和局部晚期喉鳞状细胞癌中的研究。新的预后生物标志物如甲基化特征似乎很有前景。新数据表明，与术后接受辅助治疗的患者相比，单纯手术治疗的HPV相关I期OPSCC患者生存率相同。讨论了顺铂剂量≤200mg/m²的III期HPV相关OPSCC患者总生存可能受到的负面影响。迫切期待降阶梯研究的结果，以便能够尽可能精确、具体地治疗HPV相关OPSCC患者，并确保其长期生活质量。
