Head and Neck Cancer: A Review.

In 2024, approximately 71 110 individuals in the US were diagnosed with head and neck cancer, and it accounted for 16 110 deaths.

2024年，美国大约有71,110人被诊断出患有头颈癌，该病导致了16,110人死亡。

observations

Approximately 90% of head and neck cancers are squamous cell carcinomas.

大约90%的头颈部癌症是鳞状细胞癌。

Worldwide, tobacco and alcohol use are the most prevalent risk factors.

在全球范围内，吸烟和饮酒是头颈部癌症最常见的风险因素。

In the US and Europe, 60% to 70% of newly diagnosed oropharynx cancers (a subset of head and neck cancers) are caused by human papillomavirus (HPV) infection.

在美国和欧洲，60%至70%新诊断的口咽癌（头颈癌的一个亚型）是由人类乳头瘤病毒（HPV）感染引起的。

At presentation, approximately 30% of patients with head and neck cancer have early-stage or localized disease (tumor <4 cm without regional lymph nodes involvement), 60% have locoregionally advanced disease (tumor ≥4 cm with local invasion and/or regional lymphadenopathy) and 10% have metastatic disease.

在初次就诊时，大约30%的头颈癌患者表现为早期或局部性疾病（肿瘤小于4厘米且无区域淋巴结转移），60%的患者表现为局部晚期疾病（肿瘤≥4厘米且伴有局部侵袭和/或区域淋巴结肿大），10%的患者表现为转移性疾病。

Up to 10% of oropharynx squamous cell carcinomas present as squamous cell carcinomas of unknown primary.

多达10%的口咽鳞状细胞癌表现为未知原发部位的鳞状细胞癌。

Standard treatment for localized head and neck cancer is surgery or radiotherapy, which are each associated with a 5-year overall survivalrate of 70% to 90%.

局部头颈部癌症的标准治疗方法是手术或放疗，这两种方法的5年总生存率分别为70%至90%。

For locoregionally advanced head and neck cancer, multimodality treatment includes surgery followed by postoperative radiation with or without chemotherapy or concomitant chemotherapy (with cisplatin as the preferred agent), and radiation with surgery is reserved for persistent or recurrent disease.

对于局部晚期头颈部癌症，多模式治疗包括手术后进行放疗，可选择是否配合化疗或同步化疗（顺铂为首选药物），对于持续或复发的疾病，保留放疗联合手术的方案。

With these treatments for locoregionally advanced head and neck cancer, 5-year overall survivalrates are 25% to 60% and more than 80% for HPV-associated oropharynx cancer.

通过这些治疗方法，局部晚期头颈部癌症的5年总生存率为25%至60%，而与HPV相关的口咽癌的5年总生存率超过80%。

Choice of treatment for locoregionally advanced head and neck cancer should involve shared decision-making and consideration of effects on speech and swallow function and appearance.

局部晚期头颈部癌症的治疗选择应涉及共同决策，并考虑对言语和吞咽功能以及外观的影响。

First-line treatment for patients with incurable locoregional recurrences or distant metastatic disease is immunotherapy with programmed death ligand-1 inhibition (ie, pembrolizumab) alone or in combination with platinum-doublet chemotherapy.

对于不可治愈的局部复发或远处转移性疾病的患者，一线治疗是免疫疗法，即单独使用程序性死亡配体-1抑制剂（例如，帕博利尤单抗）或与铂类双药化疗联合使用。

With treatment, patients with incurable locoregional recurrences or distant metastatic disease have a median survival of 12 to 15 months, and 5-year survival rates are less than 20%.

经过治疗，不可治愈的局部复发或远处转移性疾病的患者中位生存期为12至15个月，5年生存率低于20%。

conclusions_and_relevance

Head and neck cancer is the seventh most common cancer worldwide.

头颈部癌症是全球第七大常见癌症。

In the US and Europe, 60% to 70% of incident oropharynx cancers are associated with HPV infection.

在美国和欧洲，60%至70%的新发口咽癌病例与人乳头瘤病毒（HPV）感染相关。

Standard treatment for localized head and neck cancer is surgery or radiotherapy.

局部头颈部癌症的标准治疗手段是手术或放射治疗。

Locoregionally advanced disease is treated with surgery followed by radiation with or without chemotherapy or concurrent chemoradiation.

局部晚期疾病首先接受手术治疗，随后进行放射治疗，可选择性地配合化疗或同步放化疗。

First-line treatment for advanced disease is immunotherapy alone or with chemotherapy.

晚期疾病的首选治疗是单独使用免疫治疗或与化疗联合使用。