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[复发性头颈癌的当前治疗选择]

[Current therapy options in recurrent head and neck cancer].

作者信息

Boehm A, Wichmann G, Mozet C, Dietz A

机构信息

Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde/Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstrasse 10-14, 04103, Leipzig, Deutschland.

出版信息

HNO. 2010 Aug;58(8):762-9. doi: 10.1007/s00106-010-2156-0.

Abstract

Recurrent disease is one of the main reasons for the persistently poor prognosis of squamous cell carcinoma of the head and neck (HNSCC; European 5-year survival, 42%). The main treatment option for primary and secondary malignancy as well as recurrent disease is surgical therapy. If R0 resection (resection margin >5 mm) for a primary tumor is not viable, survival probability is reduced by 50%. In recurrent or secondary tumors with R1- or -2 resection or in the presence of non-resectable metastases, a palliative situation results in more than 80% of cases. In the case of surgery following radiotherapy or radiochemotherapy, attention should be paid to the criteria for salvage surgery (tissue perfusion, fibrosis, wound healing) and the procedure adapted to focus on functionality. In the case of relapse, primary surgery can potentially be supplemented with adjuvant therapy protocols such as (re-) irradiation, as well as possibly with chemotherapeutic agents or targeted therapies. Interdisciplinary collaboration and case discussions should take place in the context of a tumor board.

摘要

复发性疾病是头颈部鳞状细胞癌(HNSCC;欧洲5年生存率为42%)预后持续不佳的主要原因之一。原发性和继发性恶性肿瘤以及复发性疾病的主要治疗选择是手术治疗。如果对原发性肿瘤进行R0切除(切除边缘>5mm)不可行,生存概率会降低50%。在R1或R2切除的复发性或继发性肿瘤中,或存在不可切除的转移灶时,超过80%的病例会出现姑息性情况。在放疗或放化疗后进行手术时,应注意挽救性手术的标准(组织灌注、纤维化、伤口愈合)以及适应功能的手术程序。在复发的情况下,原发性手术可能会辅以辅助治疗方案,如(再)放疗,以及可能的化疗药物或靶向治疗。应在肿瘤专家委员会的背景下进行多学科协作和病例讨论。

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