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免疫疗法联合标准疗法治疗头颈部鳞状细胞癌的Meta 分析。

Immunotherapy Combined With Standard Therapies in Head and Neck Squamous Cell Carcinoma - A Meta-analysis.

机构信息

Department of Medical Oncology, Barts Cancer Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, U.K.

Integrated Symptom Control and Palliative Care Team, The Royal Marsden NHS Foundation Trust, London, U.K.

出版信息

Anticancer Res. 2024 Mar;44(3):861-878. doi: 10.21873/anticanres.16880.

Abstract

Head and neck squamous cell carcinoma (HNSCC) is a deadly disease with a poor prognosis due to late diagnosis and limited treatment options. Immunotherapy (IT) is emerging as a promising approach, especially after the failure of standard of care therapies (STs). The objective of this systematic review and meta-analysis was to evaluate whether the addition of IT to STs improves outcomes for patients with HNSCC, including overall survival (OS), progression-free survival (PFS), and quality of life (QoL). This review employed the Population Intervention Comparison and Outcome (PICO) framework to identify relevant search terms in electronic databases, and also included supplementary hand searches. Six primary research articles were selected using the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) flow chart, and were critically appraised. Data extraction from these studies was conducted, and a meta-analysis was performed to aid in the generation of forest plots. The addition of IT to standard anticancer therapies was found to enhance patient outcomes, such as OS, PFS, and QoL. The toxicity profile of IT was acceptable, with minimal treatment-related deaths. The most frequently observed adverse events (AE) were related to the skin, followed by hematological toxicities. Based on our analysis, the addition of IT to STs is a suitable treatment option and is supported by current research. However, further studies are needed to investigate factors that influence treatment effectiveness and to develop optimal therapies. To achieve this, we recommend a comprehensive treatment approach that involves the multidisciplinary team (MDT) and patient assessment tools.

摘要

头颈部鳞状细胞癌(HNSCC)是一种预后较差的致命疾病,这是由于诊断较晚和治疗选择有限所致。免疫疗法(IT)作为一种有前途的方法正在出现,尤其是在标准治疗方法(ST)失败之后。本系统评价和荟萃分析的目的是评估 IT 联合 ST 是否能改善 HNSCC 患者的预后,包括总生存期(OS)、无进展生存期(PFS)和生活质量(QoL)。本综述采用人群干预比较和结局(PICO)框架来确定电子数据库中相关的搜索词,并进行了补充人工检索。使用系统评价和荟萃分析(PRISMA)流程图选择了六篇主要的研究文章,并进行了批判性评价。从这些研究中提取数据,并进行荟萃分析以帮助生成森林图。结果发现,将 IT 联合标准抗癌疗法可以改善患者的预后,如 OS、PFS 和 QoL。IT 的毒性谱是可以接受的,只有少数与治疗相关的死亡。最常见的不良反应(AE)与皮肤有关,其次是血液学毒性。根据我们的分析,将 IT 联合 ST 是一种合适的治疗选择,得到了现有研究的支持。然而,需要进一步的研究来调查影响治疗效果的因素,并开发最佳的治疗方法。为此,我们建议采用综合治疗方法,包括多学科团队(MDT)和患者评估工具。

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