頭 頸部 がん: 概要
Lara A Dunn1,2, Alan L Ho1,2, David G Pfister1,2
1Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
JAMA
|December 15, 2025
まとめ
よく見られる悪性腫瘍である頭頸部がんは たばこ,アルコール,ヒトパピローマウイルス (HPV) と関連しています. 治療法は段階によって異なりますが,進行した病気の重要な選択肢として免疫療法が登場しています.
科学分野:
- 腫瘍学
- 癌 研究
背景:
- 頭頸部がんは 世界で7番目に多く見られる癌で 上部消化管に影響します
- 状細胞癌はこれらのがんのおよそ90%を占め,喫煙とアルコールが主な危険因子です.
- ヒューマン・パピローマウイルス (HPV) 感染症は,米国とヨーロッパにおける口がんの重要な原因である.
研究 の 目的:
- 頭頸部がんの発生率,危険因子,ステージング,現在の治療方法を概説する.
- 異なるステージと治療方法に関連した生存率を強調する.
- 口腔がんにおけるHPVの役割と 免疫療法を含む治療の発展を強調する.
主な方法:
- 頭頸部がんの発生率と死亡率に関する疫学データのレビュー
- タバコ,アルコール,HPV感染などの危険因子の分析
- 癌の段階 (局所的,局所的に進行した,転移) に基づく標準治療プロトコルに関する記述
- 様々な治療戦略の生存結果の要約
主要な成果:
- 手術や放射線療法で治療された局所的な頭頸がんの5年生存率は70~90%です.
- 局所的に進行した疾患の治療では5年生存率は25~60%で,HPV関連口がんでは80%以上です.
- 免疫療法で治療された進行または転移した疾患は,生存期間の中央値12〜15ヶ月と5年生存率<20%を示しています.
結論:
- 頭頸部がんの治療の決定には 機能的・美学的結果を考慮した 共同意思決定が必要です
- 免疫療法,特にPD-L1阻害は,治療不能の進行または再発した頭頸部がんの第一線治療です.
- HPVに関連した口がんは,適切な治療で予後が良くなります.
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