Pashley N R
J Otolaryngol. 1980 Oct;9(5):405-11.
Head and neck cancer patients who develop incurable recurrent tumors present the surgical team with unique problems dissimilar to patients with cancer of other areas. When the structures of the head and neck are violated by tumor, the dying process is slow, lingering, and painful; and the anatomic areas involved tend to be visible, difficult to shield from those in attendance, and of course, are very obvious to the patient. This review offers some practical guidelines for the management of head and neck cancer pain, nutrition, anorexia, odor control, mental confusion, and local control of visible tumor. Our approach includes the palliative use of surgery, radiotherapy, and chemotherapy, and the participation of members of a palliative team by which therapeutic decisions and timing can be individualized for each patient. This system of palliation offers significant advantages to the patient and to the surgeon, and is a new concept applicable to head and neck cancer patients for whom previously little could be offered.
出现无法治愈的复发性肿瘤的头颈癌患者给外科团队带来了与其他部位癌症患者不同的独特问题。当肿瘤侵犯头颈结构时，死亡过程缓慢、迁延且痛苦；所涉及的解剖区域往往肉眼可见，难以对在场人员隐瞒，当然，患者自己也非常清楚。本综述提供了一些关于头颈癌疼痛、营养、厌食、气味控制、精神错乱以及可见肿瘤局部控制管理的实用指南。我们的方法包括姑息性地使用手术、放疗和化疗，以及姑息治疗团队成员的参与，通过他们可以为每个患者个体化制定治疗决策和确定治疗时机。这种姑息治疗系统为患者和外科医生带来了显著优势，是一个适用于此前几乎无计可施的头颈癌患者的新概念。
