HPV相关口咽癌诊疗现状及治疗研究进展

何美霖; 易俊林

doi:10.13201/j.issn.2096-7993.2023.09.009

HPV相关口咽癌诊疗现状及治疗研究进展

何美霖¹,
易俊林^1, ,

- 国家癌症中心肿瘤临床研究中心北京协和医学院中国医学科学院肿瘤医院放疗科(北京，100021)

详细信息

通讯作者: 易俊林，E-mail：yijunlin1969@cicams.ac.cn

中图分类号: R739.8

收稿日期: 2023-07-18

刊出日期: 2023-09-03

Research progress in diagnosis and treatment of HPV-associated oropharyngeal squamous cell carcinoma

HE Meilin¹,
YI Junlin^1, ,

- Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

More Information

Corresponding author: YI Junlin, E-mail: yijunlin1969@cicams.ac.cn

Received Date: 18 July 2023

Publish Date: 03 September 2023

摘要

摘要: 口咽癌是常见的头颈部恶性肿瘤之一。近年来，人乳头状瘤病毒相关性口咽鳞状细胞癌(human papilloma virus-associated oropharyngeal squamous cell carcinoma，HPV-OPSCC)发病率呈逐年上升趋势。随着外科微创手术技术的进步、调强放射治疗的广泛应用，以及患者对器官功能保护和更高生活质量的需求，HPV-OPSCC独特的生物学行为和较好的预后引发了一系列减毒治疗模式的探索。现结合相关报道就口咽癌诊疗现状及相关研究进展做一综述。
- 口咽肿瘤 /
- 人乳头状瘤病毒相关口咽肿瘤 /
- 诊断 /
- 治疗策略 /
- 预后
Abstract: Oropharyngeal carcinoma is one of the most common malignant tumors of head and neck. In recent years, the incidence of Human papilloma virus-associated oropharyngeal squamous cell carcinoma(HPV-OPSCC) has been increasing year by year. With the advancement of minimally invasive surgical techniques, the wide application of intensity modulated radiation therapy, and the demand of patients for organ function protection and higher quality of life, the unique biological behavior and better prognosis of HPV-OPSCC have led to the exploration of a series of attenuated treatment modes. This article reviews the diagnosis and treatment status of oropharyngeal cancer and related research progress based on relevant reports.
- oropharyngeal carcinoma /
- HPV-associated oropharyngeal cancer /
- diagnosis /
- treatment strategy /
- prognosis

HTML全文

参考文献(40)

[1]	Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods[J]. Int J Cancer, 2019, 144(8): 1941-1953. doi: 10.1002/ijc.31937
[2]	Liu J, Yang XL, Zhang SW, et al. Correction to: Incidence, mortality, and temporal patterns of oropharyngeal cancer in China: a population-based study[J]. Cancer Commun(Lond), 2019, 39(1): 6.
[3]	Machiels JP, René Leemans C, Golusinski W, et al. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up[J]. Ann Oncol, 2020, 31(11): 1462-1475. doi: 10.1016/j.annonc.2020.07.011
[4]	Marur S, D'Souza G, Westra WH, et al. HPV-associated head and neck cancer: a virus-related cancer epidemic[J]. Lancet Oncol, 2010, 11(8): 781-789. doi: 10.1016/S1470-2045(10)70017-6
[5]	Liu J, Yang XL, Zhang SW, et al. Correction to: Incidence, mortality, and temporal patterns of oropharyngeal cancer in China: a population-based study[J]. Cancer Commun(Lond), 2019, 39(1): 6.
[6]	Xu T, Shen C, Wei Y, et al. Human papillomavirus(HPV)in Chinese oropharyngeal squamous cell carcinoma(OPSCC): A strong predilection for the tonsil[J]. Cancer Med, 2020, 9(18): 6556-6564. doi: 10.1002/cam4.3339
[7]	Wiest T, Schwarz E, Enders C, et al. Involvement of intact HPV16 E6/E7 gene expression in head and neck cancers with unaltered p53 status and perturbed pRb cell cycle control[J]. Oncogene, 2002, 21(10): 1510-1517. doi: 10.1038/sj.onc.1205214
[8]	Cianchetti M, Mancuso AA, Amdur RJ, et al. Diagnostic evaluation of squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site[J]. Laryngoscope, 2009, 119(12): 2348-2354. doi: 10.1002/lary.20638
[9]	Shi W, Kato H, Perez-Ordonez B, et al. Comparative prognostic value of HPV16 E6 mRNA compared with in situ hybridization for human oropharyngeal squamous carcinoma[J]. J Clin Oncol, 2009, 27(36): 6213-6221. doi: 10.1200/JCO.2009.23.1670
[10]	Lydiatt WM, Patel SG, O'Sullivan B, et al. Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual[J]. CA Cancer J Clin, 2017, 67(2): 122-137. doi: 10.3322/caac.21389
[11]	Fakhry C, Lacchetti C, Rooper LM, et al. Human Papillomavirus Testing in Head and Neck Carcinomas: ASCO Clinical Practice Guideline Endorsement of the College of American Pathologists Guideline[J]. J Clin Oncol, 2018, 36(31): 3152-3161. doi: 10.1200/JCO.18.00684
[12]	Gillison ML, Koch WM, Capone RB, et al. Evidence for a causal association between human papillomavirus and a subset of head and neck cancers[J]. J Natl Cancer Inst, 2000, 92(9): 709-720. doi: 10.1093/jnci/92.9.709
[13]	Huang SH, Xu W, Waldron J, et al. Refining American Joint Committee on Cancer/Union for International Cancer Control TNM stage and prognostic groups for human papillomavirus-related oropharyngeal carcinomas[J]. J Clin Oncol, 2015, 33(8): 836-845. doi: 10.1200/JCO.2014.58.6412
[14]	Prevc A, Kranjc S, Cemazar M, et al. Dose-Modifying Factor of Radiation Therapy with Concurrent Cisplatin Treatment in HPV-Positive Squamous Cell Carcinoma: A Preclinical Study[J]. Radiat Res, 2018, 189(6): 644-651. doi: 10.1667/RR14984.1
[15]	Wang H, Wang B, Wei J, et al. Molecular mechanisms underlying increased radiosensitivity in human papillomavirus-associated oropharyngeal squamous cell carcinoma[J]. Int J Biol Sci, 2020, 16(6): 1035-1043. doi: 10.7150/ijbs.40880
[16]	Bristow RG, Benchimol S, Hill RP. The p53 gene as a modifier of intrinsic radiosensitivity: implications for radiotherapy[J]. Radiother Oncol, 1996, 40(3): 197-223. doi: 10.1016/0167-8140(96)01806-3
[17]	Ang KK, Harris J, Wheeler R, et al. Human papillomavirus and survival of patients with oropharyngeal cancer[J]. N Engl J Med, 2010, 363(1): 24-35. doi: 10.1056/NEJMoa0912217
[18]	Rios Velazquez E, Hoebers F, Aerts HJ, et al. Externally validated HPV-based prognostic nomogram for oropharyngeal carcinoma patients yields more accurate predictions than TNM staging[J]. Radiother Oncol, 2014, 113(3): 324-330. doi: 10.1016/j.radonc.2014.09.005
[19]	Fakhry C, Zhang Q, Nguyen-Tan PF, et al. Development and Validation of Nomograms Predictive of Overall and Progression-Free Survival in Patients With Oropharyngeal Cancer[J]. J Clin Oncol, 2017, 35(36): 4057-4065. doi: 10.1200/JCO.2016.72.0748
[20]	Nguyen AT, Luu M, Mallen-St Clair J, et al. Comparison of Survival After Transoral Robotic Surgery vs Nonrobotic Surgery in Patients With Early-Stage Oropharyngeal Squamous Cell Carcinoma[J]. JAMA Oncol, 2020, 6(10): 1555-1562. doi: 10.1001/jamaoncol.2020.3172
[21]	Nichols AC, Theurer J, Prisman E, et al. Radiotherapy versus transoral robotic surgery and neck dissection for oropharyngeal squamous cell carcinoma(ORATOR): an open-label, phase 2, randomised trial[J]. Lancet Oncol, 2019, 20(10): 1349-1359. doi: 10.1016/S1470-2045(19)30410-3
[22]	Nichols AC, Theurer J, Prisman E, et al. Randomized Trial of Radiotherapy Versus Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma: Long-Term Results of the ORATOR Trial[J]. J Clin Oncol, 2022, 40(8): 866-875. doi: 10.1200/JCO.21.01961
[23]	Palma DA, Prisman E, Berthelet E, et al. Assessment of Toxic Effects and Survival in Treatment Deescalation With Radiotherapy vs Transoral Surgery for HPV-Associated Oropharyngeal Squamous Cell Carcinoma: The ORATOR2 Phase 2 Randomized Clinical Trial[J]. JAMA Oncol, 2022, 8(6): 1-7.
[24]	Eisbruch A, Schwartz M, Rasch C, et al. Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can they be spared by IMRT?[J]. Int J Radiat Oncol Biol Phys, 2004, 60(5): 1425-1439. doi: 10.1016/j.ijrobp.2004.05.050
[25]	Eisbruch A. Dysphagia and aspiration following chemo-irradiation of head and neck cancer: major obstacles to intensification of therapy[J]. Ann Oncol, 2004, 15(3): 363-364. doi: 10.1093/annonc/mdh117
[26]	Robbins KT. Barriers to winning the battle with head-and-neck cancer[J]. Int J Radiat Oncol Biol Phys, 2002, 53(1): 4-5. doi: 10.1016/S0360-3016(02)02713-X
[27]	Gillison ML, Trotti AM, Harris J, et al. Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer(NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial[J]. Lancet, 2019, 393(10166): 40-50. doi: 10.1016/S0140-6736(18)32779-X
[28]	Mehanna H, Robinson M, Hartley A, et al. Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer(De-ESCALaTE HPV): an open-label randomised controlled phase 3 trial[J]. Lancet, 2019, 393(10166): 51-60. doi: 10.1016/S0140-6736(18)32752-1
[29]	Rischin D, King M, Kenny L, et al. Randomized Trial of Radiation Therapy With Weekly Cisplatin or Cetuximab in Low-Risk HPV-Associated Oropharyngeal Cancer(TROG 12.01)-A Trans-Tasman Radiation Oncology Group Study[J]. Int J Radiat Oncol Biol Phys, 2021, 111(4): 876-886. doi: 10.1016/j.ijrobp.2021.04.015
[30]	Yom SS, Torres-Saavedra P, Caudell JJ, et al. Reduced-Dose Radiation Therapy for HPV-Associated Oropharyngeal Carcinoma(NRG Oncology HN002)[J]. J Clin Oncol, 2021, 39(9): 956-965. doi: 10.1200/JCO.20.03128
[31]	Chera BS, Amdur RJ, Green R, et al. Phase Ⅱ Trial of De-Intensified Chemoradiotherapy for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma[J]. J Clin Oncol, 2019, 37(29): 2661-2669. doi: 10.1200/JCO.19.01007
[32]	Tsai CJ, McBride SM, Riaz N, et al. Evaluation of Substantial Reduction in Elective Radiotherapy Dose and Field in Patients With Human Papillomavirus-Associated Oropharyngeal Carcinoma Treated With Definitive Chemoradiotherapy[J]. JAMA Oncol, 2022, 8(3): 364-372. doi: 10.1001/jamaoncol.2021.6416
[33]	Misiukiewicz K, Gupta V, Miles BA, et al. Standard of care vs reduced-dose chemoradiation after induction chemotherapy in HPV+ oropharyngeal carcinoma patients: The Quarterback trial[J]. Oral Oncol, 2019, 95: 170-177. doi: 10.1016/j.oraloncology.2019.06.021
[34]	Marur S, Li S, Cmelak AJ, et al. E1308: Phase Ⅱ Trial of Induction Chemotherapy Followed by Reduced-Dose Radiation and Weekly Cetuximab in Patients With HPV-Associated Resectable Squamous Cell Carcinoma of the Oropharynx-ECOG-ACRIN Cancer Research Group[J]. J Clin Oncol, 2017, 35(5): 490-497. doi: 10.1200/JCO.2016.68.3300
[35]	Villaflor VM, Melotek JM, Karrison TG, et al. Response-adapted volume de-escalation(RAVD)in locally advanced head and neck cancer[J]. Ann Oncol, 2016, 27(5): 908-913. doi: 10.1093/annonc/mdw051
[36]	Ferris RL, Flamand Y, Weinstein GS, et al. Phase Ⅱ Randomized Trial of Transoral Surgery and Low-Dose Intensity Modulated Radiation Therapy in Resectable p16+ Locally Advanced Oropharynx Cancer: An ECOG-ACRIN Cancer Research Group Trial(E3311)[J]. J Clin Oncol, 2022, 40(2): 138-149. doi: 10.1200/JCO.21.01752
[37]	Swisher-McClure S, Lukens JN, Aggarwal C, et al. A Phase 2 Trial of Alternative Volumes of Oropharyngeal Irradiation for De-intensification(AVOID): Omission of the Resected Primary Tumor Bed After Transoral Robotic Surgery for Human Papilloma Virus-Related Squamous Cell Carcinoma of the Oropharynx[J]. Int J Radiat Oncol Biol Phys, 2020, 106(4): 725-732. doi: 10.1016/j.ijrobp.2019.11.021
[38]	Seiwert TY, Foster CC, Blair EA, et al. OPTIMA: a phase Ⅱ dose and volume de-escalation trial for human papillomavirus-positive oropharyngeal cancer[J]. Ann Oncol, 2019, 30(10): 1673. doi: 10.1093/annonc/mdz171
[39]	Price K, Van Abel KM, Moore EJ, et al. Long-Term Toxic Effects, Swallow Function, and Quality of Life on MC1273: A Phase 2 Study of Dose De-escalation for Adjuvant Chemoradiation in Human Papillomavirus-Positive Oropharyngeal Cancer[J]. Int J Radiat Oncol Biol Phys, 2022, 114(2): 256-265. doi: 10.1016/j.ijrobp.2022.05.047
[40]	Owadally W, Hurt C, Timmins H, et al. PATHOS: a phase Ⅱ/Ⅲ trial of risk-stratified, reduced intensity adjuvant treatment in patients undergoing transoral surgery for Human papillomavirus(HPV)positive oropharyngeal cancer[J]. BMC Cancer, 2015, 15: 602. doi: 10.1186/s12885-015-1598-x