Department of Radiation Oncology, The Princess Margaret Cancer Centre/University Health Network, Toronto, ON, Canada; Department of Otolaryngology - Head and Neck Surgery, The University of Toronto, Toronto, ON, Canada.
Department of Supportive Care, The Princess Margaret Cancer Centre/University Health Network, Toronto, ON, Canada; Department of Otolaryngology - Head and Neck Surgery, The University of Toronto, Toronto, ON, Canada.
Semin Radiat Oncol. 2018 Jan;28(1):64-74. doi: 10.1016/j.semradonc.2017.08.008.
Cancers of the head and neck and the treatments required to control them frequently result in serious and persistent impairments that can affect participation and quality of life. Increased recognition of the needs of cancer survivors and their caregivers has prompted research focused on the unique concerns of this complex group. Unmet needs have been identified among 60-70% of patients and a similar proportion of their partners; impacts can include profound social effects, isolation, and psychiatric conditions. Interprofessional teams, supplementing oncology nursing and physicians with physical rehabilitation, occupational therapy, speech-language pathology, nutrition and psychological disciplines is important to address the spectrum of emotional, cognitive, physical and functional, and pragmatic issues. In addition to investigating modified anti-cancer therapy intended to reduce the frequency of long-term toxicities, supportive care strategies that may be effective include physical activity, nutritional intervention, behavioral and cognitive-behavioral therapy, psycho-education and goal management therapy. This article addresses identified needs across varied domains, the current state of research surrounding them, and their impact on quality of life, while also describing one cancer center's approach to head and neck cancer survivorship.
头颈部癌症及其治疗方法常常导致严重且持久的损伤，从而影响参与和生活质量。越来越多的人认识到癌症幸存者及其照顾者的需求，促使人们专注于研究这一复杂群体的独特问题。60%-70%的患者及其伴侣存在未满足的需求；这些影响包括严重的社会影响、孤立和精神疾病。多专业团队的建立很重要，除了肿瘤护理和医生之外，还需要配备物理康复、职业治疗、言语-语言病理学、营养和心理学科的专业人员，以解决情感、认知、身体和功能以及实际问题方面的一系列问题。除了研究旨在减少长期毒性发生频率的改良抗癌疗法外，可能有效的支持性护理策略还包括体育活动、营养干预、行为和认知行为疗法、心理教育和目标管理疗法。本文讨论了不同领域的已确定需求、围绕这些需求的研究现状及其对生活质量的影响，同时还描述了一家癌症中心对头颈部癌症患者生存问题的处理方法。
