Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
Department of Psychiatry and James Psychosocial Oncology, The Ohio State University, Columbus, Ohio.
Otolaryngol Head Neck Surg. 2020 Aug;163(2):356-363. doi: 10.1177/0194599820912029. Epub 2020 Mar 17.
Patients with head and neck cancer (HNC) face a unique set of unmet needs. A subset of these patients experience symptom control challenges related to their disease burden and treatments. A multidisciplinary approach involving palliative medicine is underutilized but crucial to identify and address these concerns. There is limited information on palliative integration with head and neck oncology.
Case series with planned data collection.
Academic quaternary care center.
We provide descriptive analyses of patients with HNC, including psychodiagnostic assessment and validated quality-of-life screening, from patients' first encounter at outpatient palliative medicine.
HNC (N = 80) contributed the greatest number of palliative referrals (25%) between 2010 and 2012. This cohort was 74% male and 79% Caucasian with a mean age of 53 years (95% CI, 51.1-54.9) and with stage IV disease of the oral cavity (28%) or oropharynx (31%). Sixty-three percent of patients had no evidence of disease. Seventy-five percent had a psychological history based on criteria (), and 70% had a history of substance use disorder. The most distressing quality-of-life concerns were pain, housing and financial problems, and xerostomia.
Patients with HNC who were referred to palliative medicine are burdened by multiple physical, psychological, substance use, and social challenges. We recommend comprehensive cancer-specific screening, such as the James Supportive Care Screening, to triage patients to appropriate supportive care services. Palliative care is one of many services that these patients may need, and it should be utilized at any point of the disease trajectory rather than reserved for end-of-life care.
头颈部癌症（HNC）患者存在一系列独特的未满足需求。其中一部分患者由于疾病负担和治疗方法而面临着控制症状的挑战。多学科的姑息治疗方法虽未得到充分利用，但对于识别和解决这些问题至关重要。目前关于姑息治疗与头颈部肿瘤学结合的信息有限。
有计划数据收集的病例系列。
学术四级保健中心。
我们对头颈部癌症患者（包括心理诊断评估和经过验证的生活质量筛查）进行描述性分析，这些患者是在姑息医学门诊首次就诊时纳入的。
在 2010 年至 2012 年期间，HNC（N=80）是姑息治疗转诊中数量最多的（占 25%）。该队列中 74%为男性，79%为白种人，平均年龄为 53 岁（95%CI，51.1-54.9），IV 期口腔癌（28%）或口咽癌（31%）。63%的患者没有疾病证据。根据标准（），75%的患者有心理病史，70%的患者有药物使用障碍史。最困扰生活质量的问题是疼痛、住房和经济问题以及口干。
转至姑息医学的头颈部癌症患者承受着多种身体、心理、药物使用和社会挑战。我们建议进行全面的癌症特异性筛查，如詹姆斯支持性护理筛查，以便将患者分诊至适当的支持性护理服务。姑息治疗是这些患者可能需要的众多服务之一，应在疾病轨迹的任何阶段使用，而不仅仅是在生命末期。
