Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Suite 1445, Houston, TX, 77030, USA.
Curr Oncol Rep. 2019 Jul 29;21(9):82. doi: 10.1007/s11912-019-0831-1.
Cutaneous squamous cell carcinoma is the second most common dermatologic malignancy worldwide. A major risk factor for development of new lesions and more aggressive disease is immunosuppression. This study is aimed at summarizing the current knowledge of the treatment of cutaneous squamous cell carcinoma of the head and neck (cSCCHN) in immunosuppressed patients.
As the variety of pharmaceutical alternatives for immunosuppression expands, the application of immunosuppression has increased. As the population at risk for cSCCHN due to immunosuppression has increased, our understanding of link between immunosuppression and cancer has expanded. In addition to surgery, adjuvant radiotherapy and systemic therapy remain major players in high-risk patients with cSCCHN. While immunotherapy demonstrates promise in immunocompetent cSCCHN patients, its role in immunosuppressed patients still needs to be delineated. Immunosuppressed patients are at higher risk of developing synchronous cSCCHN, each with an increased risk of recurrence. While surgery remains mainstay of treatment, further understanding is required to delineate the evolving role of adjuvant and potentially neoadjuvant therapies.
皮肤鳞状细胞癌是全世界第二大常见的皮肤恶性肿瘤。新病变和更具侵袭性疾病的主要危险因素是免疫抑制。本研究旨在总结目前对免疫抑制患者头颈部皮肤鳞状细胞癌(cSCCHN)的治疗认识。
随着免疫抑制药物替代物的种类不断增加,免疫抑制的应用也在增加。由于免疫抑制导致发生 cSCCHN 的风险人群增加,我们对免疫抑制与癌症之间关系的认识也在不断扩大。除手术外,辅助放疗和全身治疗仍然是高危 cSCCHN 患者的主要治疗方法。虽然免疫疗法在免疫功能正常的 cSCCHN 患者中显示出良好的疗效,但在免疫抑制患者中的作用仍需进一步阐明。免疫抑制患者发生同步 cSCCHN 的风险更高,且每种疾病的复发风险均增加。虽然手术仍然是主要的治疗方法,但仍需要进一步了解,以明确辅助治疗和潜在新辅助治疗的不断变化的作用。