HPV 阳性口咽癌的降阶梯治疗研究:我们应如何进行?

De-escalation studies in HPV-positive oropharyngeal cancer: How should we proceed?

机构信息

Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora; Department of Maxillofacial Surgery Poznan University of Medical Sciences, Poland.

Department Radiation Oncology, GenesisCare St Vincent's Hospital, Melbourne, Australia.

出版信息

Oral Oncol. 2021 Dec;123:105620. doi: 10.1016/j.oraloncology.2021.105620. Epub 2021 Nov 17.

Abstract

Human papilloma virus (HPV) is a well-established causative factor in a subset of squamous cell carcinomas of the head and neck (HNSCC). Although HPV can be detected in various anatomical subsites, HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) is the most common HPV-related malignancy of the head and neck, and its worldwide incidence is constantly rising. Patients with OPSCC are generally younger, have less co-morbidities and generally have better prognosis due to different biological mechanisms of carcinogenesis. These facts have generated hypotheses on potential treatment modifications, aiming to minimize treatment-related toxicities without compromising therapy efficacy. Numerous randomized clinical trials have been designed to verify this strategy and increasingly real-world evidence data from retrospective, observational studies is becoming available. Until now, the data do not support any modification in contemporary treatment protocols. In this narrative review, we outline recent data provided by both randomized controlled trials and real-world evidence of HPV-positive OPSCC in terms of clinical value. We critically analyze the potential value and drawbacks of the available data and highlight future research directions. This article was written by members and invitees of the International Head and Neck Scientific Group.(www.IHNSG.com).

摘要

人乳头瘤病毒(HPV)是头颈部鳞状细胞癌(HNSCC)中某些亚型的明确致病因素。尽管 HPV 可在多种解剖部位检测到,但 HPV 阳性口咽鳞状细胞癌(OPSCC)是头颈部最常见的 HPV 相关恶性肿瘤,其全球发病率不断上升。OPSCC 患者通常较年轻,合并症较少,由于致癌的生物学机制不同,总体预后较好。这些事实引发了关于潜在治疗方法改变的假设,旨在在不影响治疗效果的情况下最大限度地减少治疗相关的毒性。已经设计了许多随机临床试验来验证这一策略,并且越来越多来自回顾性观察研究的真实世界证据数据也开始出现。到目前为止,这些数据并不支持对当代治疗方案进行任何修改。在这篇叙述性综述中,我们根据临床价值概述了随机对照试验和 HPV 阳性 OPSCC 的真实世界证据提供的最新数据。我们批判性地分析了现有数据的潜在价值和缺点,并强调了未来的研究方向。本文由国际头颈部科学组(www.IHNSG.com)的成员和特邀人员撰写。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索