局部晚期头颈部鳞状细胞癌免疫治疗MDT专家共识（2025年版）

郭晔; 胡超苏; 张陈平

doi:10.19401/j.cnki.1007-3639.2025.11.010

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局部晚期头颈部鳞状细胞癌免疫治疗MDT专家共识（2025年版）

指南与共识 | 更新时间：2025-12-31

- 局部晚期头颈部鳞状细胞癌免疫治疗MDT专家共识（2025年版）
- MDT consensus on immunotherapy for locally advanced head and neck squamous cell carcinoma (2025 edition)
- 中国癌症杂志 2025年35卷第11期页码：1076-1089
- 作者机构：
  
  中国临床肿瘤学会头颈肿瘤专家委员会
- 作者简介：
  
  [ "郭晔（ORCID: 0000-0002-1813-9815），博士，主任医师。" ]
  胡超苏（ORCID: 0000-0001-6407-3311），博士，主任医师，E-mail: hucsu62@163.com；
  张陈平（ORCID: 0009-0002-4399-5792），博士，主任医师，E-mail: zhang.chenping@hotmail.com。
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2025.11.010
  中图分类号： R739.91
- 收稿：2025-09-15，
  
  修回：2025-11-04，
  
  纸质出版：2025-11-30
- 稿件说明：
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郭晔, 胡超苏, 张陈平. 局部晚期头颈部鳞状细胞癌免疫治疗MDT专家共识（2025年版）[J]. 中国癌症杂志, 2025,35(11):1076-1089.

Ye GUO, Chaosu HU, Chenping ZHANG. MDT consensus on immunotherapy for locally advanced head and neck squamous cell carcinoma (2025 edition)[J]. China Oncology, 2025, 35(11): 1076-1089.
郭晔, 胡超苏, 张陈平. 局部晚期头颈部鳞状细胞癌免疫治疗MDT专家共识（2025年版）[J]. 中国癌症杂志, 2025,35(11):1076-1089. DOI： 10.19401/j.cnki.1007-3639.2025.11.010.

Ye GUO, Chaosu HU, Chenping ZHANG. MDT consensus on immunotherapy for locally advanced head and neck squamous cell carcinoma (2025 edition)[J]. China Oncology, 2025, 35(11): 1076-1089. DOI： 10.19401/j.cnki.1007-3639.2025.11.010.

摘要

约2/3的头颈部鳞状细胞癌患者就诊时处于局部晚期，即便采用多学科团队（multidisciplinary team，MDT）的诊疗模式，其治疗结局仍有待改进。免疫治疗已经成为复发转移性头颈部鳞状细胞癌的标准治疗，近年来在局部晚期特别是围手术期的临床研究中获得了初步成功，但在不同场景具体应用方面依然面临诸多问题。中国临床肿瘤学会头颈肿瘤专家委员会组织专家基于循证医学证据及临床实践探索，经过多轮讨论，最终形成14条共识意见。本共识全面涵盖局部晚期头颈部鳞状细胞癌免疫治疗的各种治疗场景，归纳如下：① 在全程治疗策略方面，对于拟接受根治性手术及辅助放化疗的局部晚期头颈部鳞状细胞癌患者，推荐采用新辅助免疫治疗、免疫治疗联合放化疗及辅助免疫治疗的全程治疗模式。② 在新辅助治疗阶段，对于需要进行新辅助免疫治疗的患者，建议选择免疫治疗联合化疗方案，疗程为2~3个周期；对于新辅助治疗后影像学评估显示肿瘤缓解且需要保留器官功能的非口腔癌患者，应采用根治性放疗。③ 免疫治疗联合放疗阶段目前尚存在争议，其最佳治疗方案和适用人群有待进一步临床研究探索。④ 在辅助免疫治疗阶段，对于具有高危因素的局部晚期头颈部鳞状细胞癌患者，术后推荐采用辅助放疗联合免疫治疗的综合方案，辅助免疫治疗的疗程为6~12个月。本共识将有利于指导局部晚期头颈部鳞状细胞癌免疫治疗的规范化应用，并且为下一步的临床研究奠定基础，力求提高国内局部晚期头颈部鳞状细胞癌免疫治疗的研究水平。本共识已在国际实践指南注册与透明化平台（Practice guideline REgistration for transPAREncy，PREPARE）上注册，注册号为PREPARE-2025CN1241。

Abstract

Approximately two-thirds of patients with head and neck squamous cell carcinoma present with locally advanced disease at the time of consultation. Even with the multidisciplinary team (MDT) diagnosis and treatment model

their treatment outcomes still need improvement. Immunotherapy has become the standard treatment for recurrent and metastatic head and neck squamous cell carcinoma. In recent years

it has achieved initial success in clinical studies on locally advanced diseases

especially in the perioperative period

but its application in other treatment fields still faces many problems. The Head and Neck Cancer Committee of Chinese Society of Clinical Oncology organized experts to form 14 consensus opinions through multiple rounds of discussions informed by evidence-based medical evidence and clinical practice. Thess consensus statements were finally formulated

comprehensively covering the entire management of immunotherapy for locally advanced head and neck squamous cell carcinoma

summarized as follows: ① Regarding the whole-course treatment strategy

for patients with locally advanced head and neck squamous cell carcinoma undergoing radical surgery followed by adjuvant chemoradiotherapy

a comprehensive treatment approach combining neoadjuvant immunotherapy

immunotherapy combined with chemoradiotherapy

and adjuvant immunotherapy is recommended. ② In the neoadjuvant treatment phase

for patients requiring neoadjuvant immunotherapy

the combination of immunotherapy with chemotherapy is recommended

with a course of 2-3 cycles. For non-oral cancer patients who achieve radiological tumor response after neoadjuvant treatment and require organ preservation

definitive radiotherapy should be administered. ③ The immunotherapy combined with radiotherapy phase remains controversial

and the optimal treatment regimen and patient selection criteria require further clinical investigation. ④ In the adjuvant immunotherapy phase

for locally advanced head and neck squamous cell carcinoma patients with high-risk factors

the combination of adjuvant radiotherapy with immunotherapy is recommended postoperatively

with a course of adjuvant immunotherapy ranging from 6 to 12 months. Corresponding recommendation levels for different treatment scenarios are obtained through voting. This consensus will help guide the standardized application of immunotherapy for locally advanced head and neck squamous cell carcinoma

lay the foundation for further clinical research

and strive to promote the research level of immunotherapy for locally advanced head and neck squamous cell carcinoma in China.This consensus has been registered on the Practice guideline REgistration for transPAREncy (PREPARE) platform

with the registration number PREPARE-2025CN1241.

关键词

Keywords

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