Simcock R, Simo R
Sussex Cancer Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.
Clin Oncol (R Coll Radiol). 2016 Jul;28(7):451-8. doi: 10.1016/j.clon.2016.03.004. Epub 2016 Apr 16.
Treatments for head and neck cancer are improving, yet they remain toxic and challenging. The incidence of some forms of head and neck cancer (e.g. oropharyngeal) is rising. This creates an enlarging cohort of survivors with complex needs. These needs may be overlooked and undertreated. This overview presents evidence for the unmet survivorship needs of head and neck cancer patients and identifies strategies for the recognition and remedy of these needs in the clinic. There is sufficient evidence to challenge services to redesign follow-up strategies around unmet need using the full multidisciplinary team and to widen focus away from a sole aim of recognition and treatment of recurrent disease. Problems presented include depression, comorbid disease, second malignancy, alcohol and nicotine dependence, eating and drinking difficulties (including dysphagia, dental problems, trismus and sense disturbance) and hypothyroidism.
头颈癌的治疗正在改善，但仍然具有毒性且颇具挑战性。某些形式的头颈癌（如口咽癌）的发病率正在上升。这使得有复杂需求的幸存者群体不断扩大。这些需求可能被忽视且治疗不足。本综述提供了证据，证明头颈癌患者未得到满足的生存需求，并确定了在临床中识别和解决这些需求的策略。有充分的证据促使医疗服务机构围绕未得到满足的需求重新设计随访策略，充分利用多学科团队，并拓宽关注点，不再仅仅着眼于识别和治疗复发性疾病。所呈现的问题包括抑郁症、合并症、第二原发性恶性肿瘤、酒精和尼古丁依赖、饮食困难（包括吞咽困难、牙齿问题、牙关紧闭和感觉障碍）以及甲状腺功能减退。
