摘要
目的总结新辅助免疫联合治疗方式在局部晚期头颈部鳞状细胞癌(LA-HNSCC)中的最新研究成果与临床应用现状,为优化综合治疗方案、改善LA-HNSCC患者的治疗效果和生活质量提供参考依据。方法以“头颈部肿瘤、鳞状细胞癌、新辅助治疗、免疫治疗、新辅助联合治疗、生物标志物、毒副反应”为中文关键词,以“head and neck neoplasm、squamous cell carcinoma、neoadjuvant therapy、Immunotherapy、neoadjuvant combination therapy、biomarkers、toxic and side effects”为英文关键词,检索PubMed数据库和维普数据库2010年10月-2023年8月发表的关于LA-HNSCC新辅助免疫联合治疗方面的文献。纳入标准:(1)LA-HNSCC;(2)新辅助联合免疫治疗。排除标准:(1)会议性、评论类等文献;(2)鼻咽癌相关的文献。共纳入47篇文献,其中中文文献5篇,英文文献42篇。结果基于新辅助免疫治疗的联合治疗有利于LA-HNSCC患者实现病理缓解,3个周期后病理完全缓解(pCR)率为37.0%~100%,主要病理缓解(MPR)率为40%~100%。实现病理缓解的HNSCC患者较非病理缓解者的无病生存期和总生存期更长,且差异均有统计学意义。程序性死亡配体1(PD-L1)高表达和HPV相关HNSCC作用更为明显,PD-L1高表达者客观缓解率为68.2%~100%,HPV相关HNSCC患者pCR率和MPR率分别为90%和100%。从新辅助免疫联合治疗HNSCC的毒副作用来看,3~4级治疗相关不良事件偶见,未见治疗相关死亡病例,整体可控。结论新辅助免疫联合治疗LA-HNSCC可有效提高肿瘤的客观反应率,且对PD-L1高表达及HPV相关HNSCC作用更为明显。然而新辅助免疫联合治疗对LA-HNSCC长期生存的益处有待进一步研究。
Objective To summarize the latest research results and clinical application of neoadjuvant immunotherapy in locally advanced head and neck squamous cell carcinoma(LA-HNSCC)in order to optimize the comprehensive treatment plan and improve the treatment effect and quality of life of LA-HNSCC patients.Methods Using"head and neck tumor,squamous cell carcinoma,neoadjuvant therapy,immunotherapy,neoadjuvant combination therapy,biomarkers,toxic and side effects"as Chinese and English keywords,we searched for literature on neoadjuvant immunotherapy combination for LA-HNSCC published in PubMed and VIP databases from October 2010 to August 2023.Inclusion criteria:(1)Locally advanced head and neck squamous cell carcinoma;(2)Neoadjuvant combined immunotherapy.Exclusion criteria:(1)Conference and commentary literature;(2)Nasopharyngeal carcinoma related literature.A total of 47 literature were included,including 5 Chinese literature and 42 English literature.Results Combination therapy based on neoadjuvant immunotherapy is beneficial in achieving pathological remission in patients with LA-HNSCC,with a pathologic complete response(pCR)rate of 37.0%-100%and major pathologic response(MPR)rate of 40%-100%after three cycles.Patients with HNSCC who achieved pathological remission have higher disease-free survival and overall survival than those without pathological remission,and the differences are statistically significant.The effect of high expression of programmed death-ligand 1(PD-L1)and human papillomavirus(HPV)-associated HNSCC is more obvious:the objective response rate of high expression of PD-L1 is 68.0%-100%.The pCR and MPR of HPV-associated HNSCC patients are 90%and100%.From the toxicities and side effects of neoadjuvant combined immunotherapy for HNSCC,Grade 3-4 treatmentrelated adverse events(TRAEs)are occasional,and no treatment-related deaths are found,indicating that the overall toxicity is controllable.Conclusions Neoadjuvant immunotherapy combination therapy of advanced LA-HNSCC can effectively improve the objectiv
作者
马艺轩
李晓娟
靳晴
纪鸾
乔俏
MA Yixuan;LI Xiaojuan;JIN Qing;JI Luan;QIAO Qiao(China Medical University,Shenyzng,Lizoning 110122,Chinz;Department of Radiotherapy,First Hospital of China Medical University,Shenyzng,Lizoning 110001,Chinz)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2024年第15期968-974,共7页
Chinese Journal of Cancer Prevention and Treatment
关键词
头颈部肿瘤
鳞状细胞癌
新辅助治疗
免疫治疗
新辅助联合治疗
生物标志物
毒副作用
综述文献
head and neck neoplasm
squamous cell carcinoma
neoadjuvant therapy
immunotherapy
neoadjuvant combination therapy
biomarkers
toxic and side effects
review literature
