Dolivet Gilles, Cortese Sophie, Mastronicola Romina, Phulpin Bérengère, Kaminski Marie-Christine, Mecellem Hinda, Gillon Véronique, Gangloff Pierre
Département de chirurgie oncologique/tête et cou, Centre Alexis-Vautrin, Vandoeuvre-lès-Nancy, France.
Bull Cancer. 2011 Jan;98(1):59-71.
Salvage surgeries of head and neck tumors are considered as poor satisfactory either for disease control results or for aesthetic and functional outcomes. Several improvements have been made possible since few years in all fields of oncologic treatments. A new approach must be initiated in that context, moreover since take in charge for head and neck region (exclusive initial medical treatment) let us consider an increasement of clinical situations for which a salvage therapy could be performed. The new surgery techniques have to be considered, reconstructive and guided by systems, which can improve surgical skills (navigation, robotic, sentinel node procedure, nervous detection and so on), the help of reirradiation techniques, the use of medical therapy during surgical procedure, the photodynamic therapy and all the help provided by new medical imaging and modern biology, which can determine more precisely the status of the cancer when it is taken in charge. The mastery of those techniques improvements must follow on an evolution of the concepts in the field of combined salvage treatments performed by multidisciplinary teams. Those treatments have to be realized in structures, which have the techniques and the multiple skills for allowing increasement of outcomes of those severe diseases.
头颈部肿瘤的挽救性手术，无论是在疾病控制效果方面，还是在美学和功能结果方面，都被认为满意度较低。近年来，肿瘤治疗的各个领域都取得了一些进展。在这种情况下，必须开创一种新方法，此外，由于对头颈部区域的治疗（仅初始医学治疗）使我们考虑到可能进行挽救性治疗的临床情况有所增加。必须考虑新的手术技术，即由系统引导的重建技术，这些系统可以提高手术技能（导航、机器人手术、前哨淋巴结手术、神经探测等），借助再照射技术，在手术过程中使用药物治疗、光动力疗法以及新医学成像和现代生物学提供的所有帮助，这些能够在治疗癌症时更精确地确定癌症状态。对这些技术改进的掌握必须伴随着多学科团队进行联合挽救治疗领域概念的演变。这些治疗必须在具备技术和多种技能的机构中进行，以便提高这些严重疾病的治疗效果。
