Bossi Paolo, Alfieri Salvatore
Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milano, Italy.
Curr Treat Options Oncol. 2016 Oct;17(10):53. doi: 10.1007/s11864-016-0431-3.
In the past two decades, multidisciplinary care has emerged as new way to manage cancer given the need to gather together specific areas of expertise and to discuss the variety of treatment approaches available for each patient. Of all the cancer subtypes, head and neck cancer might be considered one of the most valid areas, from an oncological point of view, for a multidisciplinary approach to be applied. Head and Neck Cancer is a complex disease area due to its varied histology and subsites, its numerous feasible treatments, its multiple typical comorbidities, and its treatment-induced toxicities whose management requires the simultaneous involvement of several professionals as part of the same health care team. However, the benefits of a multidisciplinary team approach in this particular area have not yet been properly documented in terms of survival outcomes. Moreover, there are some concerns and the limitations of a multidisciplinary team approach for Head and Neck Cancer patients are still open to question: cost-efficiency, the implications from a medical law perspective, the level of expertise required and the timing of each intervention (fixed or as required; before, during or after oncological treatment), and the role of the leader with other interested specialists to optimize all multidisciplinary care mechanisms.
在过去二十年中，鉴于需要汇聚特定专业领域并讨论针对每位患者的各种可用治疗方法，多学科护理已成为管理癌症的新方式。从肿瘤学角度来看，在所有癌症亚型中，头颈癌可能被认为是最适合应用多学科方法的领域之一。头颈癌是一个复杂的疾病领域，因其组织学和亚部位多样、可行治疗方法众多、典型合并症多样以及治疗引起的毒性反应，其管理需要同一医疗团队中的多名专业人员同时参与。然而，就生存结果而言，多学科团队方法在这一特定领域的益处尚未得到充分记录。此外，还存在一些担忧，并且多学科团队方法对头颈癌患者的局限性仍有待质疑：成本效益、从医疗法律角度的影响、所需的专业水平以及每次干预的时机（固定或按需；在肿瘤治疗之前、期间或之后），以及领导者与其他相关专家在优化所有多学科护理机制方面的作用。
