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治疗后头颈部癌患者的超声检查:随访护理效果的回顾性分析。

Ultrasound in patients with treated head and neck carcinomas: A retrospective analysis for effectiveness of follow-up care.

机构信息

Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University.

Key Laboratory of Rehabilitation Medicine in Sichuan Province.

出版信息

Medicine (Baltimore). 2021 Apr 23;100(16):e25496. doi: 10.1097/MD.0000000000025496.

Abstract

Correct follow-up is necessary to avoid under- or overtreatment in the care of patients with treated carcinomas of head and neck. Ultrasound is a cost-effective, harmless, easy, and feasible method. It can be applied in the outpatient clinic in follow-up but the United Kingdom National Multidisciplinary guidelines are recommended computed tomography or magnetic resonance imaging for the detection of metastasis for head and neck carcinomas in the follow-up period. The purpose of the study was to state that neck ultrasound would be the method of choice on follow-up care of Chinese patients who received primary treatment for carcinoma of head and neck.Patients who received primary treatment for carcinoma of the head and neck were examined for 5-years in follow-up through physical, clinical, and neck ultrasound (n = 198). If patients had no evidence of disease after 60 months of definitive therapy considered as a cure. If patients had no evidence of disease after 36 months of salvage therapy considered as a cure of recurrence.Irrespective of definitive treatment used, the study was monitored through neck ultrasound during 5 years of a follow-up visit and was reported cure in 126 (64%) patients and recurrence in 72 (36%; distant metastasis: 33 [17%], local recurrence: 24 [12%], and regional recurrence: 15 [7%]) patients. Primary tumor stage IV, III, II, and I had 63% (15/24), 51% (21/41), 32% (18/56), and 23% (18/77) recurrence, respectively. The time to detect regional recurrence was shorter than that for local recurrence (P < .0001, q = 15.059) and distant recurrence (P < .0001, q = 7.958). Local recurrence and stage I primary tumor had the highest percentage cure for recurrence.Neck ultrasound in the follow-up period is reported to be effective for the detection of recurrence of patients who received primary treatment for carcinoma of head and neck especially regional recurrence and primary tumor stage I.Level of Evidence: III.

摘要

正确的随访对于避免头颈部治疗后肿瘤患者的过度或不足治疗至关重要。超声是一种具有成本效益、无害、简便可行的方法。它可以在门诊随访中应用,但英国国家多学科指南建议在随访期间使用计算机断层扫描或磁共振成像来检测头颈部癌的转移。本研究的目的是表明,对于接受头颈部癌原发治疗的中国患者,颈部超声将成为随访护理的首选方法。

接受头颈部癌原发治疗的患者在随访中接受了 5 年的检查,包括体格检查、临床检查和颈部超声检查(n=198)。如果患者在根治性治疗后 60 个月没有疾病证据,则认为治愈。如果患者在挽救性治疗后 36 个月没有疾病证据,则认为复发治愈。

无论使用何种确定性治疗,本研究在 5 年的随访期间通过颈部超声进行监测,并报告 126 例(64%)患者治愈,72 例(36%;远处转移:33[17%],局部复发:24[12%],区域性复发:15[7%])患者复发。原发肿瘤分期 IV、III、II 和 I 的复发率分别为 63%(15/24)、51%(21/41)、32%(18/56)和 23%(18/77)。区域性复发的检测时间短于局部复发(P<0.0001,q=15.059)和远处复发(P<0.0001,q=7.958)。局部复发和 I 期原发肿瘤的复发治愈百分比最高。

头颈部癌原发治疗后患者的随访中进行颈部超声检查被报道为有效,可检测复发,特别是区域性复发和 I 期原发肿瘤。

证据水平

III。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f6f/8078385/b50dc976a52a/medi-100-e25496-g001.jpg

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