Oosting Sjoukje F, Haddad Robert I
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.
Front Oncol. 2019 Aug 27;9:815. doi: 10.3389/fonc.2019.00815. eCollection 2019.
Treating head and neck cancer patients with systemic therapy is challenging because of tumor related, patient related and treatment related factors. In this review, we aim to summarize the current standard of care in the curative and palliative setting, and to describe best practice with regard to structural requirements, procedures, and monitoring outcome. Treatment advice for individual head and neck cancer patients is best discussed within a multidisciplinary team. Cisplatin is the drug of choice for concomitant chemoradiotherapy in the primary and postoperative setting, and also a main component of induction chemotherapy. However, acute and late toxicity is often significant. Checkpoint inhibitors have recently been proven to be active in the metastatic setting which has resulted in a shift of paradigm. Detailed knowledge, institution of preventive measures, early recognition, and prompt treatment of adverse events during systemic therapy is of paramount importance. Documentation of patient characteristics, tumor characteristics, treatment details, and clinical and patient reported outcome is essential for monitoring the quality of care. Participation in initiatives for accreditation and registries for benchmarking institutional results are powerful incentives for implementation of best practice procedures.
由于肿瘤相关、患者相关和治疗相关因素，采用全身治疗方法治疗头颈癌患者具有挑战性。在本综述中，我们旨在总结当前在根治性和姑息性治疗中的护理标准，并描述在结构要求、程序和监测结果方面的最佳实践。针对个体头颈癌患者的治疗建议最好在多学科团队中进行讨论。顺铂是在原发性和术后环境中同步放化疗的首选药物，也是诱导化疗的主要组成部分。然而，急性和晚期毒性往往很严重。最近已证明检查点抑制剂在转移性环境中具有活性，这导致了治疗模式的转变。在全身治疗期间，详细了解、制定预防措施、早期识别和及时治疗不良事件至关重要。记录患者特征、肿瘤特征、治疗细节以及临床和患者报告的结果对于监测护理质量至关重要。参与认证计划和用于机构结果基准测试的注册登记是实施最佳实践程序的有力激励措施。
