Head and neck squamous cell carcinoma (HNSCC) presents as locally advanced disease in a majority of patients and is prone to relapse despite aggressive treatment. Since immune checkpoint inhibitors (ICI) have shown clinically significant efficacy in patients with recurrent/metastatic HNSCC (R/M HNSCC), a plethora of trials are investigating their role in earlier stages of disease. At the same time, preclinical data showed the synergistic role of concurrently administered radiotherapy and ICIs (immunoradiotherapy) and explained several mechanisms behind it. Therefore, this approach is prospectively tested in a neoadjuvant, definitive, or adjuvant setting in non-R/M HNSCC patients. Due to the intricate relationship between host, immunotherapy, chemotherapy, and radiotherapy, each of these approaches has its advantages and disadvantages. In this narrative review we present the biological background of immunoradiotherapy, as well as a rationale for, and possible flaws of, each treatment approach, and provide readers with a critical summary of completed and ongoing trials.

中文翻译：

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结合放疗和免疫治疗头颈鳞状细胞癌的根治性治疗：当前临床试验回顾


头颈鳞状细胞癌 (HNSCC) 在大多数患者中表现为局部晚期疾病，尽管积极治疗，但仍容易复发。由于免疫检查点抑制剂 (ICI) 对复发/转移性 HNSCC (R/M HNSCC) 患者显示出临床显着疗效，因此大量试验正在研究其在疾病早期阶段的作用。同时，临床前数据显示了同时进行放疗和 ICI（免疫放射治疗）的协同作用，并解释了其背后的几种机制。因此，该方法在非 R/M HNSCC 患者的新辅助、确定或辅助治疗中进行了前瞻性测试。由于宿主、免疫治疗、化疗和放疗之间的复杂关系，每种方法都有其优点和缺点。在这篇叙述性评论中，我们介绍了免疫放射治疗的生物学背景，以及每种治疗方法的基本原理和可能的缺陷，并为读者提供了已完成和正在进行的试验的重要总结。