Santos Luís Guilherme, Garcia Ana Rita, Teixeira Margarida
Medical Oncology Department, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, PRT.
Cureus. 2025 Feb 16;17(2):e79084. doi: 10.7759/cureus.79084. eCollection 2025 Feb.
Locally advanced head and neck squamous cell carcinoma (HNSCC) is treated with definitive concurrent chemoradiation if deemed unresectable. Contrarily to the metastatic/recurrent setting, there is no current role for immunotherapy in the locally advanced setting, all trials being negative in their primary endpoints. As such, and although it may still be performed, determination of programmed death-ligand 1 (PD-L1) is not mandatory in locally advanced disease. We aimed to assess if there was any correlation with PD-L1 positivity (when obtained), disease characteristics, and recurrence-free survival in unresectable, locally advanced HNSCC eligible for concurrent chemoradiation in a Portuguese centre. We retrospectively analysed 164 patients for five years, most of whom had unresectable stage IV disease treated with cisplatin-based chemoradiation. PD-L1 was determined in 35% of patients. While it did not correlate to anatomical disease location, treatment tolerance, p16 status, or clinical staging at diagnosis, PD-L1 over-expression seemed to identify a group of patients in which recurrence-free survival was shorter, highlighting the need for continued clinical trials assessing the role of PD-L1 testing and immunotherapy in this setting.
局部晚期头颈部鳞状细胞癌（HNSCC）如果被认为无法切除，则采用确定性同步放化疗进行治疗。与转移性/复发性情况相反，目前免疫疗法在局部晚期情况下没有作用，所有试验的主要终点均为阴性。因此，尽管仍可进行程序性死亡配体1（PD-L1）的检测，但在局部晚期疾病中并非强制要求。我们旨在评估在葡萄牙一个中心符合同步放化疗条件的无法切除的局部晚期HNSCC患者中，PD-L1阳性（如果检测到）、疾病特征和无复发生存率之间是否存在任何相关性。我们对164例患者进行了为期五年的回顾性分析，其中大多数患者患有无法切除的IV期疾病，接受了以顺铂为基础的同步放化疗。35%的患者检测了PD-L1。虽然它与解剖学疾病位置、治疗耐受性、p16状态或诊断时的临床分期无关，但PD-L1过表达似乎确定了一组无复发生存期较短的患者，这突出了继续进行临床试验以评估PD-L1检测和免疫疗法在这种情况下作用的必要性。
