局部晚期头颈部鳞状细胞癌辅助化疗:人群选择、方案优化与循证进展

doi:10.11904/j.issn.1002-3070.2025.04.014

摘要/Abstract

摘要： 头颈部鳞状细胞癌(head and neck squamous cell carcinoma,HNSCC)是一种较为常见的恶性肿瘤,因其发病部位隐匿,通常在诊断时已处于局部晚期,且复发和转移风险较高,预后较差。目前,国内外指南推荐可手术的局部晚期头颈部鳞状细胞癌患者接受手术治疗,手术后高危患者进一步行辅助放疗或同步放化疗。然而,患者对指南推荐治疗的依从性普遍较低,且预后改善不明显。因此,在临床实践中,部分患者会在根治性治疗后接受辅助化疗。本综述基于循证医学证据,系统分析了局部晚期头颈部鳞状细胞癌辅助化疗的三大核心争议:高危人群甄别、方案优化和特殊人群管理,通过梳理现有研究,旨在为临床决策和治疗方案提供循证依据,并探讨未来研究方向。

关键词: 头颈部鳞癌, 治疗, 辅助化疗, 化疗方案

Abstract: Head and neck squamous cell carcinoma(HNSCC)is a relatively common malignant tumor,which is often diagnosed in the local late stage due to its insidious location,high risk of recurrence and metastasis,and poor prognosis.At present,both domestically and internationally guidelines recommend that patients with locally advanced HNSCC who are eligible for surgical treatment.High-risk patients after surgery should further undergo adjuvant radiotherapy or concurrent chemoradiotherapy.However,patients generally have low compliance with the recommended treatment guidelines and there is no significant improvement in prognosis.Therefore,in clinical practice,some patients may receive adjuvant chemotherapy after radical treatment.This review is based on evidence-based medicine and systematically analyzes three core controversies of adjuvant chemotherapy for locally advanced HNSCC:identification of high-risk populations,optimization of treatment plans,and special population management.By reviewing existing research,it aims to provide evidence-based evidence for clinical decision-making and treatment plans,and explore future research directions.

Key words: Head and neck squamous cell carcinoma, Treatment, Adjuvant chemotherapy, Chemotherapy regimen

中图分类号:

R730.53

古丽尼克尔·开赛尔, 赵化荣. 局部晚期头颈部鳞状细胞癌辅助化疗:人群选择、方案优化与循证进展[J]. 实用肿瘤学杂志, 2025, 39(4): 348-352.

Gulnigar KAYSAR, ZHAO Huarong. Adjuvant chemotherapy for locally advanced head and neck squamous cell carcinoma:population selection,regimen optimization and evidence-based progress[J]. Journal of Practical Oncology, 2025, 39(4): 348-352.

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