Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas.
Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas.
Int J Radiat Oncol Biol Phys. 2022 Nov 15;114(4):803-811. doi: 10.1016/j.ijrobp.2022.06.086. Epub 2022 Jul 4.
Up to 40% of patients who present with, or later develop, metastatic disease from head and neck squamous cell carcinoma have oligometastatic disease, defined as 5 or fewer sites of metastasis. Patients with limited number of metastases clearly have improved overall survival compared with those with more disseminated metastases, but the risk of, and factors associated with, true oligometastatic state in head and neck cancer are not yet known. Current standard of care for patients with metastatic disease is single agent or combination systemic therapy, but the data are accumulating on the role of both metastasis-directed local ablative therapy and locoregional radiation therapy to improve outcomes. Although surgical resection has been the treatment of choice to address oligometastasis historically, stereotactic ablative radiotherapy has become a viable and less invasive alternative option with encouraging retrospective data in head and neck cancers. Biomarkers to help identify the oligometastatic state and prospective studies to better elucidate the role of local therapies are urgently needed.
高达 40%的头颈部鳞状细胞癌患者在出现或后来发展为转移性疾病时存在寡转移疾病，定义为 5 个或更少的转移部位。与转移更广泛的患者相比，转移部位有限的患者的总生存率明显提高，但头颈部癌症中真正的寡转移状态的风险和相关因素尚不清楚。目前转移性疾病患者的标准治疗方法是单药或联合全身治疗，但关于转移灶局部消融治疗和局部区域放射治疗改善预后的作用的数据正在不断积累。尽管手术切除一直是治疗寡转移的首选方法，但立体定向消融放疗已成为一种可行且侵袭性较小的替代选择，对头颈部癌症的回顾性数据令人鼓舞。迫切需要生物标志物来帮助识别寡转移状态和前瞻性研究来更好地阐明局部治疗的作用。
