头部和部癌症:一个回顾
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
概括
头癌是一种常见的恶性瘤,通常与烟草,酒精和人类乳头瘤病毒 (HPV) 有关. 治疗不同阶段不同,免疫疗法是疾病晚期的关键选择.
科学领域:
- 癌症学
- 癌症研究
背景情况:
- 头部和部癌症是全球第七大常见癌症,
- 状细胞癌约占这些癌症的90%,烟草和酒精是主要的危险因素.
- 人类乳头瘤病毒 (HPV) 感染是美国和欧洲口腔癌的重要原因.
研究的目的:
- 概述头癌的发病率,风险因素,病期和当前治疗方法.
- 突出不同阶段和治疗方法的生存率.
- 强调HPV在口腔癌中的作用以及包括免疫疗法在内的不断变化的治疗环境.
主要方法:
- 对头癌发病率和死亡率的流行病学数据的审查.
- 分析风险因素,包括烟草,酒精和HPV感染.
- 基于癌症阶段 (局部,局部发达,转移) 的标准治疗方案的描述.
- 各种治疗策略的生存结果摘要.
主要成果:
- 用手术或放射治疗治疗的局部头癌的5年生存率为70-90%.
- 区域性晚期疾病治疗的5年生存率为25- 60%,与HPV相关的口腔瘤超过80%.
- 用免疫疗法治疗的晚期或转移性疾病显示中位数存活时间为12- 15个月,而5年存活率为< 20%.
结论:
- 治疗头癌的决定需要共同决策,考虑功能和美学结果.
- 免疫疗法,特别是PD-L1抑制,是不可治愈的晚期或复发的头癌的第一线治疗方法.
- 通过适当的治疗,与HPV相关的口腔瘤的预后更好.
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