Sciubba J J
The Milton J. Dance Head and Neck Center, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Oral Dis. 2016 Nov;22(8):740-744. doi: 10.1111/odi.12506. Epub 2016 Jun 29.
Past the point of no longer being able to control malignancies of the oral cavity and head and neck, the decision-making process must shift to one that essentially concerns itself with creating comfort for the patient. The role of family, physicians, and other caregivers becomes, in many ways, more directed as active neoplasia-related concerns become less relevant. Challenges remain significant in terms of continuing management of prior treatment-related side effects and functional impairments to providers concerning themselves with maintenance of dignity, honoring the wishes of the family, and creating full understanding of on the part of all parties concerned what the goals of treatment cessation and palliation are key as death approaches.
当口腔及头颈部恶性肿瘤发展到无法再控制的阶段时，决策过程必须转向主要关注为患者创造舒适的状态。在许多方面，随着与活动性肿瘤相关的问题变得不那么重要，家庭、医生和其他护理人员的角色变得更具针对性。对于致力于维护患者尊严、尊重家属意愿并让所有相关方充分理解临近死亡时停止治疗和姑息治疗目标的医护人员来说，在持续管理先前治疗相关的副作用和功能障碍方面，挑战依然巨大。
