Bates James E, Steuer Conor E
Department of Radiation Oncology, Winship Cancer Institute, Emory University, 550 Peachtree St NE, Atlanta, GA, 30308, USA.
Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, 1365 Clifton Road, Atlanta, GA, 30307, USA.
Curr Treat Options Oncol. 2022 Mar;23(3):325-332. doi: 10.1007/s11864-022-00950-8. Epub 2022 Mar 4.
Patients with HPV-associated oropharyngeal squamous cell carcinoma have improved prognosis relatively to those with tumors not driven by HPV. Both definitive radiotherapy (typically with concurrent chemotherapy) and transoral robotic surgery (with adjuvant therapies based on pathologic risk factors) are both acceptable treatment options for patients. The decision on which treatment is optimal depends on individual patient factors and should be made in a multi-disciplinary setting with input from a radiation oncologist, head and neck surgeon, and medical oncologist. Where appropriate, patients in this setting should be considered for enrollment on clinical studies evaluating de-escalation of treatment intensity given the very favorable outcomes and high toxicity profile associated with conventional therapies. However, caution is needed given negative data for de-escalation in the definitive chemotherapy and radiation setting. It remains unclear what the prognostic significance of HPV status is in patients with squamous cell carcinomas of the head and neck outside of the oropharynx.
与人类乳头瘤病毒（HPV）相关的口咽鳞状细胞癌患者的预后相较于非HPV驱动的肿瘤患者有所改善。对于患者而言，根治性放疗（通常联合同步化疗）和经口机器人手术（根据病理风险因素进行辅助治疗）都是可接受的治疗选择。关于哪种治疗是最佳选择的决定取决于个体患者因素，并且应该在放疗肿瘤学家、头颈外科医生和肿瘤内科医生参与的多学科环境中做出。在适当的情况下，鉴于与传统疗法相关的非常良好的结果和高毒性，应考虑让处于这种情况的患者参加评估降低治疗强度的临床研究。然而，鉴于在根治性化疗和放疗环境中降低治疗强度的负面数据，需要谨慎行事。目前尚不清楚HPV状态在口咽以外的头颈鳞状细胞癌患者中的预后意义是什么。
