Jimenez-Socha Maria, Dion Gregory R, Mora-Navarro Camilo, Wang Ziyu, Nolan Michael W, Freytes Donald O
Lampe Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina-Chapel Hill, Raleigh, NC 27606, USA.
Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27606, USA.
Cancers (Basel). 2025 Mar 26;17(7):1108. doi: 10.3390/cancers17071108.
Head and neck cancer encompasses a diverse group of malignant neoplasms originating in regions such as the oral cavity, oropharynx, hypopharynx, larynx, sinonasal cavities, and salivary glands. HNC represents a significant public health challenge, and recent reports indicate an increment in the incidence of HNC in young adults. In 2020, approximately 377,700 new HNC cases and 177,800 HNC-related deaths were reported globally. Major risk factors include tobacco smoking, alcohol consumption, and human papillomavirus (HPV) infections. HNC impacts vital functions such as breathing, swallowing, and speech. Treatments for this type of cancer within this complex anatomy include surgery, radiotherapy, and chemotherapy combinations. Radiotherapy is often an essential component of both curative and palliative HNC treatment, balancing tumor control with the preservation of function and appearance. However, its use can damage adjacent normal tissues, causing acute or chronic toxicity. One complication of HNC irradiation is VF fibrosis, which leads to severe voice impairments, significantly affecting patients' quality of life. Fibrosis involves excessive and aberrant deposition of extracellular matrix, driven by factors such as TGF-β1 and inflammatory cytokines, which ultimately impair the flexibility and function of VF. Current radiation-induced fibrosis treatments primarily focus on symptom management and include systemic therapies like corticosteroids, anti-inflammatory drugs, and antioxidants. However, these treatments have limited efficacy. Experimental approaches targeting molecular pathways involved in fibrosis are being explored. Given the limitations of these treatments, advancing research is crucial to develop more effective therapeutic strategies that can significantly improve the quality of life for HNC patients, especially those vulnerable to VF fibrosis.
头颈癌涵盖了起源于口腔、口咽、下咽、喉、鼻窦腔和唾液腺等部位的多种恶性肿瘤。头颈癌是一项重大的公共卫生挑战，最近的报告显示，年轻成年人的头颈癌发病率有所上升。2020年，全球报告了约377,700例新的头颈癌病例和177,800例与头颈癌相关的死亡病例。主要风险因素包括吸烟、饮酒和人乳头瘤病毒（HPV）感染。头颈癌会影响呼吸、吞咽和言语等重要功能。在这种复杂解剖结构内，这类癌症的治疗方法包括手术、放疗和化疗联合使用。放疗通常是头颈癌根治性和姑息性治疗的重要组成部分，在控制肿瘤的同时兼顾功能和外观的保留。然而，放疗的使用可能会损害邻近的正常组织，导致急性或慢性毒性。头颈癌放疗的一个并发症是声带纤维化，这会导致严重的声音障碍，显著影响患者的生活质量。纤维化涉及细胞外基质的过度和异常沉积，由转化生长因子-β1和炎性细胞因子等因素驱动，最终损害声带的柔韧性和功能。目前针对放射性纤维化的治疗主要集中在症状管理，包括使用皮质类固醇、抗炎药和抗氧化剂等全身治疗方法。然而，这些治疗方法的疗效有限。正在探索针对参与纤维化的分子途径的实验方法。鉴于这些治疗方法的局限性，推进研究对于开发更有效的治疗策略至关重要，这些策略可以显著提高头颈癌患者，尤其是易患声带纤维化患者的生活质量。
