局部晚期头颈部鳞状细胞癌的化疗及靶向进展

doi:10.6040/j.issn.1673-3770.0.2020.276

摘要/Abstract

摘要： 局部晚期头颈部鳞状细胞癌目前主要采用手术、放疗和化疗相结合的综合治疗,但是器官功能保留率和5年生存率没有显著提高。从20世纪70年代末开始,以顺铂为基础的化疗药开始应用于局部晚期头颈部鳞状细胞癌治疗中,研究表明,顺铂联合氟尿嘧啶作为诱导化疗方案提高了喉功能保全率。后来随着紫杉醇的应用,有研究证实在PF方案基础上加用紫杉醇可提高诱导化疗的疗效。与PF方案相比,TPF方案在局部控制率及无进展生存期上有显著的优越性,因此,成为诱导化疗的首选方案。20世纪90年代初期,同步放化疗成为非手术治疗及保喉的新方式,因其在总体生存率、保喉率、局部控制率上有明确的优势,已被列入局部晚期头颈部肿瘤非手术治疗的标准治疗方案。2006年分子靶向治疗药物西妥昔单抗经美国食品和药物管理局批准运用于临床,因其预后的优势及较少的不良反应成为无法耐受化疗药物的新选择。就局部晚期头颈部鳞状细胞癌的化疗药物及靶向药物治疗进展进行综述。

关键词: 局部晚期头颈部鳞癌, 化疗, 放化疗, 诱导, 同步, 靶向

Abstract: Surgery in combination with chemotherapy and radiotherapy is the mainstay of treatment for locally advanced head and neck squamous cell carcinoma(LAHNSCC). However the organ preservation rate and 5-year survival rate have not significantly improved. In the late 1970s, cisplatin-based chemotherapeutic drugs began to be used in the treatment of LAHNSCC. Studies have shown a significant laryngeal preservation benefit of PF. With the application of paclitaxel, studies have confirmed that the TPF regimen has significant advantages in terms of local control and progression-free survival compared with PF. Therefore, it became the first choice for induction chemotherapy. In the early 1990s, concurrent chemoradiotherapy(CCRT)became a new method of non-surgical treatment and laryngeal protection. CCRT has clear advantages in terms of overall survival, laryngeal preservation, and local control and has been the standard non-surgical treatment for LAHNSCC. In 2006, cetuximab(CET)was approved by the US Food and Drug Administration for clinical use. Because of its advantages in terms of prognosis and less side effects, CET offers a new alternative for patients who cannot tolerate chemotherapy. This article reviews the progress in chemotherapy and targeted drug therapy for locally advanced head and neck squamous cell carcinoma.

Key words: Locally advanced head and neck squamous cell carcinoma, Chemotherapy, Induction chemotherapy, Concurrent chemoradiotherapy, Targeted therapy

中图分类号:

R735.1

卫亚楠,陈曦. 局部晚期头颈部鳞状细胞癌的化疗及靶向进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 118-124.

WEI Ya'nan,CHEN Xi. Progress in chemotherapy and targeted drug therapy for locally advanced head and neck squamous cell carcinoma[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(3): 118-124.

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