摘要 头颈部鳞癌(squamous cell carcinoma of the head and neck,SCCHN)就诊时约60%为局部晚期,改变分割模式的单纯放疗较常规分割放疗有显著生存优势\[1\],以顺铂为基础的同期放化疗亦使局部晚期头颈部鳞癌(locally advanced SCCHN,LA-SCCHN)的疗效提高了约6.5%,主要以<60岁人群获益\[2-3\]。对根治术后存在高危因素患者,两项Ⅲ期临床研究也表明术后同期放化疗优于单纯放疗\[4-5\]。RTOG9111研究证明同期放化疗较诱导化疗或单纯放疗提高了喉癌的保喉率\[6\]。同期放化疗虽然提高了疗效但明显增加急性不良反应,使3、4级急性黏膜炎发生率达 38%~71%\[7-8\]；SCCHN根治术后采用同期放化疗的严重急性不良反应发生率较单纯放疗增加了约1倍\[5,9\]；同期放化疗期间仅 46%~51%患者能完成计划的第3周期化疗\[7-8\]。不仅如此,同期放化疗后的严重晚期不良反应发生率亦可高达43%\[10\]。因此,寻找保持或提高疗效,同时降低不良反应、增加患者耐受性的治疗方案是LA-SCCHN治疗的研究方向之一,分子靶向药物特别是表皮生长因子受体抑制剂(epidermal growth factor receptor inhibitors,EGFRIs)在SCCHN中的应用得到越来越多的关注。
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2012, Vol. 21 
