基于免疫疗法的全身治疗与放射治疗相结合，在复发性头颈癌中取得了持久缓解和良好生存效果。
Combination of immunotherapy-based systemic therapy and radiotherapy achieves durable response and favorable survival in recurrent head and neck cancer.
作者信息
Wang Jingbo, Shayan Gulidanna, Guo Xin, Huang Xiaodong, Zhang Ye, Wu Runye, Gui Lin, Yang Sheng, Chen Xuesong, Qu Yuan, Wang Kai, Zhang Jianghu, Ma Yuchao, Luo Jingwei, Zhou Shengyu, He Xiaohui, Yi Junlin
机构信息
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
出版信息
Ther Adv Med Oncol. 2025 Sep 10;17:17588359251367358. doi: 10.1177/17588359251367358. eCollection 2025.
BACKGROUND
There is an unmet clinical need for the locoregional recurrent head and neck squamous cell carcinoma (HNSCC). Moreover, little data regarding the therapeutic survival outcomes are available for the unresectable recurrent setting that did not receive radiotherapy during the initial course of treatment.
OBJECTIVES
To investigate the survival outcomes of radiation-naïve recurrent HNSCC who were treated with first-line immunotherapy-based systemic therapy in combination with radical locoregional radiotherapy.
DESIGN
This is a retrospective study.
METHODS
From January 2019 to December 2023, locoregional recurrent HNSCC patients receiving immune checkpoint inhibitor (ICI)-based systemic therapy plus locoregional radiotherapy as first-line treatment in our institution were selected. Median follow-up was 16.4 months.
RESULTS
A total of 23 patients with recurrent HNSCC met the inclusion criteria and were finally analyzed. The median time to progression from the beginning of initial course of treatment was 9.3 months. Nineteen patients (82.6%) harbored recurrent stage IV (rIV) disease according to AJCC eighth edition, and 17 (73.9%) patients were assessed unresectable. For overall cohort, the median progression-free survival (PFS) and locoregional progression-free survival (LRPFS) were 17.0 months and 27.2 months, while the median overall survival (OS) and distant metastasis-free survival (DMFS) were not reached. The 1-year OS, PFS, LRPFS, and DMFS were 100%, 79.5%, 79.5%, and 100%, respectively. Twenty patients obtained objective response during the treatment course, achieving the 1-year duration of response (DOR) of 75.3%, and the median of 16.7 months. Combined positive score (CPS) ⩾ 20 was unveiled to be correlated with significantly favorable PFS compared with CPS < 20 or unknown (1-year PFS: 100% vs 50.0%, = 0.035).
CONCLUSION
This study presented promising survival and tumor control with durable response in recurrent HNSCC, supporting the use of radical RT as the first-line treatment in addition to ICI-based systemic therapy, in particular for patients with CPS ⩾ 20.
背景
局部区域复发性头颈部鳞状细胞癌（HNSCC）存在未满足的临床需求。此外，对于在初始治疗过程中未接受放疗的不可切除复发病例，关于治疗生存结果的数据很少。
目的
探讨未接受过放疗的复发性HNSCC患者接受一线基于免疫疗法的全身治疗联合根治性局部区域放疗后的生存结果。
设计
这是一项回顾性研究。
方法
选取2019年1月至2023年12月在本机构接受基于免疫检查点抑制剂（ICI）的全身治疗加局部区域放疗作为一线治疗的局部区域复发性HNSCC患者。中位随访时间为16.4个月。
结果
共有23例复发性HNSCC患者符合纳入标准并最终进行分析。从初始治疗开始到疾病进展的中位时间为9.3个月。根据美国癌症联合委员会（AJCC）第八版，19例（82.6%）患者为复发性IV期（rIV）疾病，17例（73.9%）患者被评估为不可切除。对于整个队列，中位无进展生存期（PFS）和局部区域无进展生存期（LRPFS）分别为17.0个月和27.2个月，而中位总生存期（OS）和无远处转移生存期（DMFS）未达到。1年的OS、PFS、LRPFS和DMFS分别为100%、79.5%、79.5%和100%。20例患者在治疗过程中获得客观缓解，1年缓解持续时间（DOR）为75.3%，中位DOR为16.7个月。与联合阳性评分（CPS）<20或未知相比，CPS≥20与显著更好的PFS相关（1年PFS：100%对50.0%，P = 0.035）。
结论
本研究显示复发性HNSCC患者具有良好的生存和肿瘤控制效果，且缓解持久，支持在基于ICI的全身治疗基础上，将根治性放疗作为一线治疗，特别是对于CPS≥20的患者。
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