摘要
鼻咽癌是一种具有显著地理和种族分布特点的头颈部恶性肿瘤,其发生、发展与Epstein-Barr病毒(EBV)感染密切相关。尽管放、化疗结合的综合治疗提高了患者的生存率,但复发和转移仍是主要挑战,尤其是局部晚期鼻咽癌(LA-NPC)。近年来,免疫治疗在LA-NPC治疗中的应用取得了重要进展,特别是基于程序性死亡蛋白-1(PD-1)及其配体PD-L1阻断的免疫检查点抑制剂(ICIs)为代表的药物均显示出了良好的抗肿瘤效果。值得注意的是,EBV阳性患者对免疫治疗表现出更高的敏感性,这与其独特的肿瘤免疫微环境特征密切相关。本文综述了近年来LA-NPC免疫治疗的研究进展,包括EBV相关免疫微环境特征、新型时序优化模式、低剂量放疗联合方案、肿瘤微环境调控及新型免疫治疗技术,并探讨其临床应用前景和挑战,以期为未来免疫治疗在LA-NPC的研究提供方向。
Nasopharyngeal carcinoma(NPC)is a distinct type of head and neck malignancy characterized by unique geographical and ethnic distribution patterns,with its pathogenesis and progression closely associated with Epstein-Barr virus(EBV)infection.Despite significant advancements in multimodal treatment strategies incorporating concurrent chemoradiotherapy,disease recurrence and metastasis continue to pose substantial clinical challenges,particularly in the management of locally advanced nasopharyngeal carcinoma(LA-NPC).In recent years,remarkable progress has been made in immunotherapeutic approaches for LA-NPC,with immune checkpoint inhibitors(ICIs)targeting the programmed cell death-1(PD-1)and its ligand PD-L1 axis emerging as a transformative therapeutic strategy,demonstrating favorable antitumor efficacy in clinical settings.Notably,EBVpositive patients exhibit enhanced sensitivity to immunotherapy,which is closely related to their unique tumor immune microenvironment characteristics.This article provides a comprehensive review of recent advancements in immunotherapy for LA-NPC,focusing on the following key areas:EBV-associated immune microenvironment characteristics,novel timing-optimized models,low-dose radiotherapy combinations,tumor microenvironment modulation,and novel immunotherapeutic technologies.Additionally,it also assesses the clinical prospects and challenges,aiming to offer strategic directions for future research in immunotherapy for LA-NPC.
作者
周平婷
罗云秀
胡越峰
王仁生
ZHOU Pingting;LUO Yunxiu;HU Yuefeng;WANG Rensheng(Hainan Cancer Hospital,Haikou 570100,China;The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《广西医科大学学报》
2025年第4期628-634,共7页
Journal of Guangxi Medical University
基金
海南省卫生健康行业科研项目(No.22A200110)。
关键词
局部晚期鼻咽癌
免疫检查点抑制剂
免疫治疗
联合治疗
肿瘤微环境
EB病毒
locally advanced nasopharyngeal carcinoma
immune checkpoint inhibitors
immunotherapy
combination therapy
tumor microenvironment
Epstein-Barr virus
