Vlastou Elena, Kougioumtzopoulou Andromachi, Platoni Kalliopi, Georgakopoulos Ioannis, Lagopati Nefeli, Kouloulias Vasileios, Zygogianni Anna
Radiotherapy Department, General Children's Hospital 'Pan. & Aglaia Kyriakou', 11527 Athens, Greece.
Department of Clinical Radiation Oncology, "ATTIKON" General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Haidari, Greece.
Cancers (Basel). 2025 Mar 6;17(5):899. doi: 10.3390/cancers17050899.
Head and neck cancer (HNC) includes various malignancies and represents the seventh most common cancer worldwide. The early diagnosis of HNC results in a 70-90% five-year survival rate, which declines with locally advanced stages of disease. Current care employs a multimodal strategy encompassing surgery, radiation therapy (RT), chemotherapy, and immunotherapy, while treatment options vary according to the stage, tumor features, and patient characteristics. About 75% of patients with HNC will benefit from RT, either as a primary treatment or as adjuvant therapy following surgical resection. Technological improvements in RT, such as intensity-modulated RT (IMRT) and image-guided RT (IGRT), have enhanced tumor targeting and minimized adjacent healthy tissue irradiation while also expanding RT to the recurrent or metastatic setting. Innovative therapeutic strategies for HNC integrate RT with immunotherapy, gene therapy, molecular targeted therapy, photodynamic therapy, photothermal therapy, and nanoparticles (NPs), with the objective of optimizing tumor control while reducing damage to normal tissues. NPs are emerging as possible radiosensitizers in HNC treatment, enhancing the efficacy of RT, chemotherapy, and immunotherapy. In vivo and in vitro studies on the irradiation of tumors containing gold (Au), gadolinium (Gd), and hafnium oxide (HfO) NPs show promising results in enhancing tumor destruction and survival rates, indicating their potential for clinical application. Hyperthermia, investigated as an adjunct treatment, potentially improves outcomes when combined with RT or chemotherapy, with advancements in nanotechnology renewing interest in this approach in HNC. At present, NBTXR3 is the sole NP that is being investigated in clinical trials for the enhancement of HNC RT.
头颈癌（HNC）包括多种恶性肿瘤，是全球第七大常见癌症。HNC的早期诊断可带来70%至90%的五年生存率，而该生存率会随着疾病局部进展阶段而下降。当前的治疗采用多模式策略，包括手术、放射治疗（RT）、化疗和免疫治疗，治疗方案会根据疾病阶段、肿瘤特征和患者特点而有所不同。约75%的HNC患者将从RT中获益，RT可作为主要治疗手段，也可作为手术切除后的辅助治疗。RT技术的改进，如调强放疗（IMRT）和图像引导放疗（IGRT），提高了肿瘤靶向性，减少了对邻近健康组织的照射，同时也将RT扩展到复发或转移的情况。HNC的创新治疗策略将RT与免疫治疗、基因治疗、分子靶向治疗、光动力治疗、光热治疗和纳米颗粒（NPs）相结合，目的是在优化肿瘤控制的同时减少对正常组织的损害。NPs正在成为HNC治疗中可能的放射增敏剂，可提高RT、化疗和免疫治疗的疗效。对含金（Au）、钆（Gd）和氧化铪（HfO） NPs的肿瘤进行照射的体内和体外研究显示，在增强肿瘤破坏和提高生存率方面取得了有前景的结果，表明它们具有临床应用潜力。热疗作为一种辅助治疗手段进行了研究，与RT或化疗联合使用时可能改善治疗效果，随着纳米技术的进步，人们对HNC的这种治疗方法重新产生了兴趣。目前，NBTXR3是唯一一种正在进行临床试验以增强HNC RT疗效的NP。
