Sandulache Vlad C, Wilde David C, Sturgis Erich M, Chiao Elizabeth Y, Sikora Andrew G
Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery Baylor College of Medicine Houston Texas U.S.A.
ENT Section, Operative Care Line Michael E. DeBakey Veterans Affairs Medical Center Houston Texas U.S.A.
Laryngoscope Investig Otolaryngol. 2019 Oct 17;4(6):617-623. doi: 10.1002/lio2.316. eCollection 2019 Dec.
Oropharyngeal squamous cell carcinoma (OPSCC) incidence is rapidly increasing in the United States and around the world, driven in large part by infection with the human papillomavirus (HPV). HPV associated OPSCC (HPV+OPSCC) has been shown to have improved response to treatment relative to tobacco-associated OPSCC. However, improvement in patient survival has not been uniform. Subsets of OPSCC patients in the US and around the world continue to have poor oncologic outcomes. Although the drivers of this phenomenon remain unclear, there is increasing evidence that tobacco exposure plays an important role in modulating HPV+OPSCC clinical outcomes.
We conducted a review of the literature.
We discuss the potential biological and epidemiological interplay between tobacco and HPV exposure in the context of OPSCC. Multiple retrospective and prospective cohorts show that HPV+OPSCC patients with a history of tobacco exposure have response to treatment and clinical outcomes distinct from HPV+OPSCC non-smokers which poses clinical and scientific challenges to be addressed over the next decade.
The interaction between tobacco exposure and HPV infection in the context of OPSCC has significant implications for both standard of care treatment regimens and development of novel therapeutic approaches, in particular those which incorporate immunomodulatory agents.
在美国及全球范围内，口咽鳞状细胞癌（OPSCC）的发病率正在迅速上升，这在很大程度上是由人乳头瘤病毒（HPV）感染所致。与烟草相关的OPSCC相比，HPV相关的OPSCC（HPV+OPSCC）已被证明对治疗的反应有所改善。然而，患者生存率的提高并不一致。美国及世界各地的部分OPSCC患者的肿瘤学结局仍然较差。尽管这一现象的驱动因素尚不清楚，但越来越多的证据表明，烟草暴露在调节HPV+OPSCC临床结局方面起着重要作用。
我们对文献进行了综述。
我们讨论了在OPSCC背景下烟草暴露与HPV暴露之间潜在的生物学和流行病学相互作用。多个回顾性和前瞻性队列研究表明，有烟草暴露史的HPV+OPSCC患者对治疗的反应和临床结局与HPV+OPSCC非吸烟者不同，这在未来十年提出了有待解决的临床和科学挑战。
在OPSCC背景下，烟草暴露与HPV感染之间的相互作用对标准治疗方案以及新型治疗方法的开发具有重要意义，尤其是那些包含免疫调节药物的治疗方法。
5级。
