用于口腔癌治疗的新辅助化疗降级:从历史上的失败到当代的HPV驱动型态
Alvaro Sanabria1, Juan P Rodrigo2, Anna Luíza Damaceno Araújo3,4
1Department of Surgery, School of Medicine, Universidad de Antioquia-Hospital Universitario San Vicente Fundacion-Clinica Somer-Clinica Las Vegas Grupo Quironsalud, Medellín 050010, Colombia.
新辅助化疗 (NAC) 在HPV阳性口腔支状细胞癌 (OPSCC) 中表现有前途,可能使治疗减缓,具有良好的生存和功能结果. 需要进一步的研究来证实这些好处.
科学领域:
- 在瘤学瘤学.
- 头部和部手术 头部和部手术
- 医学瘤学 医学瘤学
背景情况:
- 由于鉴定了由HPV驱动的疾病,口腔状细胞癌 (OPSCC) 的管理正在发展.
- 在历史上,新辅助化疗 (NAC) 在混合头癌队列中显示出有限的生存益处.
- 新兴的HPV分层数据表明,NAC可能有助于OPSCC的治疗降级.
研究的目的:
- 在HPV阳性OPSCC中对NAC进行叙述性综合证据.
- 专注于初级和节点反应,病理完整反应 (pCR),生存和功能结果.
- 评估NAC在基于手术和化疗放射治疗 (CRT) 的治疗策略中的作用.
主要方法:
- 进行了PubMed.Med的叙事审查.
- 包括报告OPSCC结果的初级研究,按HPV状况分层分层.
- 提取了关于研究设计,治疗,反应,生存和毒性的数据.
主要成果:
- 前HPV时代的研究显示了可变的NAC反应,没有明显的OS优势.
- 在HPV时代,经过手术后的NAC显示高PCR率和有利的存活率 (≥80%在3-5年).
- NAC+CRT疗法显示出高响应率,优异的存活率 (80-90%+),以及减少吞发病率.
结论:
- 随机试验尚未证实NAC在整体头癌中的OS优势.
- 新出现的证据表明,NAC在HPV阳性OPSCC中可能允许缓解手术和/或辐射.
- 这种降级显示出有希望的瘤和功能结果.
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