复发或转移性唾液腺癌的全身治疗方法：系统评价
Systemic treatments in recurrent or metastatic salivary gland cancer: a systematic review
影响因子:8.30000
分区:医学1区 Top / 肿瘤学2区
发表日期:2024 Oct
作者:
D Prost, S Iseas, M Gatineau, J Adam, S Cavalieri, C Bergamini, L Licitra, É Raymond
摘要
唾液腺癌很少经常出现，并且由于其组织学多样性和各种临床行为而构成挑战，这使得难以选择最佳的全身治疗方法，以解决高级或经常性阶段。该系统评价旨在评估四种类型的唾液癌的总体生存结果和全身治疗反应。APubMed和Google Scholar Search确定了涉及最初经过全身治疗的最初先进或复发病例的研究。根据系统评价和荟萃分析（PRISMA）清单的首选报告项目，选择了有关治疗反应和结果的明确数据的研究。在筛选的723项研究中，有44个符合我们的纳入标准。总共包括426例复发/转移性唾液腺癌病例，主要是唾液管癌（SDC； n = 219）和腺样囊肿癌（ACC; n = 167）。组织分子标记与组织学密切相关，HER2过表达和雄激素受体核表达通常在SDC和腺癌中发现，另外没有指定的病例，并且仅在ACC中过表达套件。反应率与特定的受体阻塞有关，曲妥珠单抗加化学疗法，而dicalutamide是最有效的（总体反应率分别为80％和42.8％）。此外，对治疗的反应对总体生存产生了积极影响（反应者与非反应者中间月相比38个； p <0.001）。在对特定队列的这种回顾性分析中，组织学类型的生存结果表明，抗人类表皮生长因子受体2治疗对SDC更有效，而化学疗法对ACCStypy.Stysic疗法更有效。对治疗的反应受组织学亚型和治疗特异性的严重影响。
Abstract
Salivary gland cancers are infrequent and pose a challenge owing to their histological diversity and varied clinical behavior, making the selection of optimal systemic treatments for advanced or recurrent stages difficult. This systematic review aims to assess overall survival outcomes and systemic treatment responses across four types of salivary cancers.A PubMed and Google Scholar search identified studies involving initially advanced or relapsed cases undergoing systemic treatment. Studies with clear, individualized data on treatment responses and outcomes were selected based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Of the 723 studies screened, 44 met our inclusion criteria.A total of 426 cases of recurrent/metastatic salivary gland cancer, mostly salivary duct carcinoma (SDC; n = 219) and adenoid cyst carcinoma (ACC; n = 167), were included. Histomolecular markers were heavily associated with histology, with HER2 overexpression and androgen receptor nuclear expression typically found in SDC and adenocarcinoma not otherwise specified cases and KIT overexpression only in ACC. The response rates were associated with specific receptor blockage, with trastuzumab plus chemotherapy, and bicalutamide being the most effective (overall response rate 80% and 42.8%, respectively). Moreover, the response to treatment positively influenced overall survival (responders 38 versus non-responders 18.7 median months; P < 0.001). In this retrospective analysis of a particular cohort, survival outcomes per histology types showed that anti-human epidermal growth factor receptor 2 therapy was more effective for SDC, while chemotherapy was more effective for ACC.Systemic treatments contribute to the survival of patients with salivary gland cancer at relapsed or newly advanced stages. The response to treatment is heavily influenced by histological subtype and treatment specificity.