Head and Neck Squamous Cell Carcinoma: Update on Epidemiology, Diagnosis, and Treatment
Head and Neck Squamous Cell Carcinoma: Update on Epidemiology, Diagnosis, and Treatment
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DOI：
10.1016/j.mayocp.2015.12.017
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发表时间：
2016-03-01
影响因子：
8.9
通讯作者：
Forastiere, Arlene A.
中科院分区：
文献类型：
--
作者：
Marur, Shanthi;Forastiere, Arlene A.
鳞状细胞癌起源于头颈部的多个解剖部位。发生口腔、口咽、下咽和喉癌的风险因素包括烟草暴露和酒精依赖，致癌病毒感染与鼻咽、腭和口咽舌扁桃体中发生的癌症相关。发达国家人乳头瘤病毒相关口咽癌的发病率正在增加，到2020年，年发病率可能超过宫颈癌。早期头颈部鳞状细胞癌的治疗通常是单一模式，手术或放射治疗。局部晚期头颈癌的治疗是多模式的，手术后辅助放疗或根据病理特征进行放化疗或确定性放化疗。对于不适合局部或区域挽救方法的复发性疾病和转移性疾病，需要使用或不使用生物制剂进行化疗。迄今为止，分子检测尚未影响头颈癌的治疗选择。这篇综述将关注头颈部鳞状细胞癌的流行病学变化、诊断进展和治疗选择，沿着口咽癌特定风险分层的数据，并将突出当前试验的方向。(C)2016年马约医学教育和研究基金会
Squamous cell carcinoma arises from multiple anatomic subsites in the head and neck region. The risk factors for development of cancers of the oral cavity, oropharynx, hypopharynx, and larynx include tobacco exposure and alcohol dependence, and infection with oncogenic viruses is associated with cancers developing in the nasopharynx, palatine, and lingual tonsils of the oropharynx. The incidence of human papillomavirus-associated oropharyngeal cancer is increasing in developed countries, and by 2020, the annual incidence could surpass that of cervical cancer. The treatment for early-stage squamous cell cancers of the head and neck is generally single modality, either surgery or radiotherapy. The treatment for locally advanced head and neck cancers is multimodal, with either surgery followed by adjuvant radiation or chemoradiation as indicated by pathologic features or definitive chemoradiation. For recurrent disease that is not amenable to a salvage local or regional approach and for metastatic disease, chemotherapy with or without a biological agent is indicated. To date, molecular testing has not influenced treatment selection in head and neck cancer. This review will focus on the changing epidemiology, advances in diagnosis, and treatment options for squamous cell cancers of the head and neck, along with data on risk stratification specific to oropharyngeal cancer, and will highlight the direction of current trials. (C) 2016 Mayo Foundation for Medical Education and Research