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局部晚期下咽癌综合治疗进展
罗希, 易俊林
国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科 100021
Research progress on multi-disciplinary combined therapy for locally advanced hypopharyngeal carcinoma
Luo Xi, Yi Junlin
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
Abstract：Hypopharyngeal carcinoma is one of the worst prognosis among head and neck cancers with a reported 5-year overall survival (OS) rate of 25%-35%. Because of the important position and function of hypopharynx, the preservation of organ function and improvement of survival are equally important. Multi-disciplinary combined treatment modality is playing a more and more pivotal role. The optimal combined modalities of surgery, radiotherapy, chemotherapy and molecular targeted therapy have been constantly modified, so the survival rate and organ function preservation rate have been gradually increased. As the surge of immunotherapy, immunotherapy combined with chemoradiotherapy in the treatment of hypopharyngeal cancer has become a highlight field. In this article, the research progress on multi-disciplinary combined treatment and the future direction in the treatment of hypopharyngeal carcinoma were mainly introduced.
Luo Xi,Yi Junlin. Research progress on multi-disciplinary combined therapy for locally advanced hypopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2020, 29(7): 578-582.
[1] Hall SF, Groome PA, Irish J, et al. The natural history of patients with squamous cell carcinoma of the hypopharynx[J]. Laryngoscope, 2008, 118(8):1362-1371. DOI:10.1097/mlG.0b013e318173dc4a. [2] Muir C, Weiland L. Upper aerodigestive tract cancers[J]. Cancer, 1995, 75(1 Suppl):147-153. DOI:10.1002/1097-0142(19950101)75:1+<147::aid-cncr2820751304>3.0.co;2-u. [3] AvinçsalMO, Shinomiya H, Teshima M, et al. Impact of alcohol dehydrogenase-aldehyde dehydrogenase polymorphism on clinical outcome in patients with hypopharyngeal cancer[J]. Head Neck, 2018, 40(4):770-777. DOI:10.1002/hed.25050. [4] Koo BS, Lim YC, Lee JS, et al. Management of contralateral N0 neck in pyriform sinus carcinoma[J]. Laryngoscope, 2006, 116(7):1268-1272. DOI:10.1097/01.mlg.0000225936.88411.71. [5] Chung EJ, Lee SH, Baek SH, et al. Pattern of cervical lymph node metastasis in medial wall pyriform sinus carcinoma[J]. Laryngoscope, 2014, 124(4):882-887. DOI:10.1002/lary.24299. [6] Kim SY, Rho YS, Choi EC, et al. Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer[J]. BMC Cancer, 2017, 17(1):904. DOI:10.1186/s12885-017-3880-6. [7] Kotwall C, Sako K, Razack MS, et al. Metastatic patterns in squamous cell cancer of the head and neck[J]. Am J Surg, 1987, 154(4):439-442. DOI:10.10 16/0002-9610(89)90020-2. [8] Carvalho AL, Nishimoto IN, Califano JA, et al. Trends in incidence and prognosis for head and neck cancer in the United States:a site-specific analysis of the SEER database[J]. Int J Cancer, 2005, 114(5):806-816. DOI:10.1002/ijc.20740. [9] De Angelis R, Sant M, Coleman MP, et al. Cancer survival in Europe 1999-2007 by country and age:results of EUROCARE—5-a population-based study[J]. Lancet Oncol, 2014, 15(1):23-34. DOI:10.101 6/S1470-2045(13)70546-1. [10] Wolf GT, Fisher SG, Hong WK, et al. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer[J]. N Engl J Med, 1991, 324(24):1685-1690. DOI:10.1056/NEJM199106133242402. [11] Lefebvre JL, Chevalier D, Luboinski B, et al. Larynx preservation in pyriform sinus cancer:preliminary results of a European Organization for Research and Treatment of Cancer phase Ⅲ trial. EORTC Head and Neck Cancer Cooperative Group[J]. J Natl Cancer Inst, 1996, 88(13):890-899. DOI:10.1093/jnci/88.13. 890. [12] Forastiere AA, Goepfert H, Maor M, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer[J]. N Engl J Med, 2003, 349(22):2091-2098. DOI:10.1056/NEJMoa03 1317. [13] Forastiere AA, Zhang Q, Weber RS, et al. Long-term results of RTOG 91-11:a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer[J]. J Clin Oncol, 2013, 31(7):845-852. DOI:10.1200/JCO.2012.43.6097. [14] Prades JM, Lallemant B, Garrel R, et al. Randomized phase Ⅲ trial comparing induction chemotherapy followed by radiotherapy to concomitant chemoradiotherapy for laryngeal preservation in T3M0 pyriform sinus carcinoma[J]. Acta Otolaryngol, 2010, 130(1):150-155. DOI:10.3109/00016480902914080. [15] Lefebvre JL, Rolland F, Tesselaar M, et al. Phase 3 randomized trial on larynx preservation comparing sequential vs. alternating chemotherapy and radiotherapy[J]. J Natl Cancer Inst, 2009, 101(3):142-152. DOI:10.1093/jnci/djn460. [16] Henriques De Figueiredo B, Fortpied C, Menis J, et al. Long-term update of the 24954 EORTC phase Ⅲ trial on larynx preservation[J]. Eur J Cancer, 2016, 65(1):10 9-112. DOI:10.1016/j.ejca.2016.06.024. [17] Yoon MS, Chung WK, Ahn SJ, et al. Concurrent chemoradiotherapy with cisplatin and fluorouracil for locally advanced hypopharyngeal carcinoma[J]. Acta Otolaryngol, 2008, 128(5):590-596. DOI:10. 1080/00016480701596021. [18] Pignon JP, Bourhis J, Domenge C, et al. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma:three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer[J]. Lancet, 2000, 355(9208):949-955. [19] Blanchard P, Baujat B, Holostenco V, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC):a comprehensive analysis by tumour site[J]. Radiother Oncol, 2011, 100(1):33-40. DOI:10.1016/j.radonc.2011.05.036. [20] 易俊林, 高黎, 徐震纲, 等. 术前同期放化与单纯放疗局部晚期头颈部鳞癌的Ⅲ期临床研究[J]. 中华放射肿瘤学杂志, 2011, 20(5):363-367. DOI:10.3760/cma.j.issn.1004-4221.2011.05.001. Yi JL, Gao L, Xu ZG, et al. Phase Ⅲ study of preoperative concurrent chemoradiotherapy compared with preoperative radiotherapy alone in the treatment of locally advanced head and neck squamous cell carcinoma[J]. Chin J Radiat Oncol, 2011, 20(5):363-367. DOI:10.3760/cma.j.issn.10 04-4221.2011.05.001. [21] 易俊林, 曲媛, 徐国镇, 等. 术前同步放化与术前单放治疗局部晚期头颈部鳞癌长期随访结果[C]. 北京:北京放射肿瘤学术论坛, 2014. Yi JL, Qu Y, Xu GZ, et al. Phase Ⅲ study of preoperative concurrent chemoradiotherapy compared with preoperative radiotherapy alone in the treatment of locally advanced head and neck squamous cell carcinoma[C]. Beijing:Beijing radiation oncology academic forum, 2014. [22] 黄辉, 徐震纲, 唐平章, 等. 梨状窝癌术前同步放化疗对手术并发症影响的临床研究[J]. 中华耳鼻喉头颈外科杂志, 2011, 46(2):114-117. DOI:10.3760/cma.j.issn.1673-0860.2011.02.006 Huang H, Xu GZ, Tang PZ, et al. Clinical analysis of surgical complications after preoperative concurrent chemoradiotherapy of pyriform sinus cancer[J]. Chin J Otorhinolaryngol Head Neck Surg, 2011, 46(2):114-117. DOI:10.3760/cma.j.issn.1673-0860.2011.02.006 [23] 张宗敏, 唐平章, 徐震纲, 等. 不同术前放射治疗剂量在下咽鳞癌综合治疗中的意义[J]. 中华放射肿瘤学杂志, 2004, 13(1):1-3. Zhang ZM,Tang PZ, Xu ZG, et al. Significance of different preoperative radiotherapy doses in combined therapy for hypopharyngeal squamous cell carcinoma[J]. Chin J Radiat Oncol, 2004, 13(1):1-3. [24] Yi J, Huang X, Xu Z, et al. Phase Ⅲ randomized trial of preoperative concurrent chemoradiotherapy versus preoperative radiotherapy for patients with locally advanced head and neck squamous cell carcinoma[J]. Oncotarget, 2017, 8(27):44842-44850. DOI:10.18632/oncotarget.15107. [25] Vermorken JB, Remenar E, van Herpen C, et al. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer[J]. N Engl J Med, 2007, 357(17):1695-1704. DOI:10.1056/NEJMoa071028. [26] Posner MR, Hershock DM, Blajman CR, et al. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer[J]. N Engl J Med, 2007, 357(17):1705-1715. DOI:10.1056/NEJMoa070956. [27] Pointreau Y, Garaud P, Chapet S, et al. Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation[J]. J Natl Cancer Inst, 2009, 101(7):498-506. DOI:10.1093/jnci/djp007. [28] Haddad R, O'Neill A, Rabinowits G, et al. Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM):a randomised phase 3 trial[J]. Lancet Oncol, 2013, 14(3):257-264. DOI:10.1016/S1470-2045(13)70011-1. [29] Cohen EE, Karrison TG, Kocherginsky M, et al. Phase Ⅲ randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer[J]. J Clin Oncol, 2014, 32(25):2735-2743. DOI:10.1200/JCO.2013.54.6309. [30] Hitt R, Grau JJ, López-Pousa A, et al. A randomized phase Ⅲ trial comparing induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as treatment of unresectable head and neck cancer[J]. Ann Oncol, 2014, 25(1):216-225. DOI:10.1093/annonc/mDT461. [31] Ghi MG, Paccagnella A, Ferrari D, et al. Induction TPF followed by concomitant treatment versus concomitant treatment alone in locally advanced head and neck cancer. A phase Ⅱ-Ⅲ trial[J]. Ann Oncol, 2017, 28(9):2206-2212. DOI:10.1093/annonc/mdx 299. [32] Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck[J]. N Engl J Med, 2006, 354(6):567-578. DOI:10.1056/NEJMoa053422. [33] Lefebvre JL, Pointreau Y, Rolland F, et al. Induction chemotherapy followed by either chemoradiotherapy or bioradiotherapy for larynx preservation:the TREMPLIN randomized phase Ⅱ study[J]. J Clin Oncol, 2013, 31(7):853-859. DOI:10.1200/JCO.2012.42.3988. [34] Masuda M, Wakasaki T, Toh S, et al. Utility of chemoradioselection for the optimization of treatment intensity in advanced hypopharyngeal and laryngeal carcinoma[J]. Mol Clin Oncol, 2017, 7(6):965-970. DOI:10.3892/mco.2017.1466. [35] Hoffman HT, Karnell LH, Shah JP, et al. Hypopharyngeal cancer patient care evaluation[J]. Laryngoscope, 1997, 107(8):1005-1017. DOI:10.1097/00005537-199708000-00001. [36] Colevas AD, Yom SS, Pfister DG, et al. NCCN guidelines insights:head and neck cancers, version 1.2018[J]. J Natl Compr Canc Netw, 2018, 16(5):479-490. DOI:10.6004/jnccn.2018.0026. [37] Singer S, Danker H, Guntinas-Lichius O, et al. Quality of life before and after total laryngectomy:results of a multicenter prospective cohort study[J]. Head Neck, 2014, 36(3):359-368. DOI:10.1002/hed.23305. [38] Putten L, Bree R, Doornaert PA, et al. Salvage surgery in post-chemoradiation laryngeal and hypopharyngeal carcinoma:outcome and review[J]. Acta Otorhinolaryngol Ital, 2015, 35(3):162-172. [39] Sewnaik A, Keereweer S, Al-Mamgani A, et al. High complication risk of salvage surgery after chemoradiation failures[J]. Acta Otolaryngol, 2012, 132(1):96-100. DOI:10.3109/00016489.2011.617779. [40] Sassler AM, Esclamado RM, Wolf GT. Surgery after organ preservation therapy. Analysis of wound complications[J]. Arch Otolaryngol Head Neck Surg, 1995, 121(2):162-165. DOI:10.1001/archotol.1995.018 90020024006. [41] Harrington KJ, Ferris RL, Blumenschein G Jr, et al. Nivolumab versus standard, single-agent therapy of investigator's choice in recurrent or metastatic squamous cell carcinoma of the head and neck (CheckMate 141):health-related quality-of-life results from a randomised, phase 3 trial[J]. Lancet Oncol, 2017, 18(8):1104-1115. DOI:10.1016/s1470-2045(17)30421-7. [42] Zandberg DP, Strome SE. The role of the PD-L1:PD-1 pathway in squamous cell carcinoma of the head and neck[J]. Oral Oncol, 2014, 50(7):627-632. DOI:10.106/ j.oraloncology.2014.04.003. [43] Kim HS, Lee JY, Lim SH, et al. Association between PD-L1 and HPV status and the prognostic value of PD-L1 in oropharyngeal squamous cell carcinoma[J]. Cancer Res Treat, 2016, 48(2):527-536. DOI:10.41 43/crt.2015.249. [44] Oliveira-Costa JP, de Carvalho AF, da Silveira da GG, et al. Gene expression patterns through oral squamous cell carcinoma development:PD-L1 expression in primary tumor and circulating tumor cells[J]. Oncotarget, 2015, 6(25):20902-20920. DOI:10. 18632/oncotarget.3939. [45] Ferris RL, Blumenschein G Jr, Fayette J, et al. Nivolumab for Recurrent Squamous-Cell Carcinoma of the Head and Neck[J]. N Engl J Med, 2016, 375(19):1856-1867. DOI:10.1056/NEJMoa1602252. [46] Chow LQM, Haddad R, Gupta S, et al. Antitumor activity of pembrolizumab in biomarker-unselected patients with recurrent and/or metastatic head and neck squamous cell carcinoma:results from the phase Ib KEYNOTE-012 expansion cohort[J]. J Clin Oncol, 2016, 34(32):3838-3845. DOI:10.1200/JCO.2016.68.1478. [47] Bauml J, Seiwert TY, Pfister DG, et al. Pembrolizumab for platinum-and cetuximab-refractory head and neck cancer:results from a single-arm, phase Ⅱ study[J]. J Clin Oncol, 2017, 35(14):1542-1549. DOI:10.1200/JCO.2016.70.1524. [48] Starr P. Encouraging results for pembrolizumab in head and neck cancer[J]. Am Heal Drug Benef, 2015, 8(Spec Issue):16. [49] Cohen EEW, Soulières D, Le Tourneau C, et al. Pembrolizumab versus methotrexate, docetaxel, or cetuximab for recurrent or metastatic head-and-neck squamous cell carcinoma (KEYNOTE-040):a randomised, open-label, phase 3 study[J]. Lancet, 2019, 393(1016 7):156-167. DOI:10.1016/S0140-6736(18)31999-8. [50] Herrera FG, Bourhis J, Coukos G. Radiotherapy combination opportunities leveraging immunity for the next oncology practice[J]. CA Cancer J Clin, 2017, 67(1):65-85. DOI:10.3322/caac.21358. [51] Shaverdian N, Lisberg AE, Bornazyan K, et al. Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer:a secondary analysis of the KEYNOTE-001 phase Ⅰ trial[J]. Lancet Oncol, 2017, 18(7):895-903. DOI:10.1016/s1470-2045(17)30380-7.
2020, Vol. 29 
