Fortunato L, Ridge J A
Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Curr Probl Cancer. 1995 May-Jun;19(3):153-65. doi: 10.1016/s0147-0272(06)80008-5.
Palliative care in head and neck cancer has not been studied systematically. Patients with incurable head and neck tumors may live months and even years. Ideal palliation should enable them to engage in a normal life before death ensues. It is likely that our improving ability to treat these tumors without achieving cures will cause people to live longer with their cancer. Hence, the need for palliation will probably increase. Also, treatments that cure patients produce conditions that require palliation. Achievement of the best possible function is the major consideration in dealing with head and neck tumors. Difficulty with speech, swallowing, oral hygiene, and laodorous tumors are all common. Depression too should be addressed in a comprehensive fashion by the "head and neck team". The surgeon, radiotherapist, and medical oncologist will need help from dentists, prosthodontists, dental hygienists, psychiatrists, physiatrists, occupational and physical therapists, visiting nurses, nutritionists, and social workers. Palliative care in the hospital is the least desirable, although often unavoidable. Proper hospice support will benefit patients and their families.
头颈部癌症的姑息治疗尚未得到系统研究。患有无法治愈的头颈部肿瘤的患者可能存活数月甚至数年。理想的姑息治疗应使他们在死亡降临前能够过上正常生活。我们在不实现治愈的情况下治疗这些肿瘤的能力不断提高，这可能会使人们患癌后存活时间更长。因此，对姑息治疗的需求可能会增加。此外，治愈患者的治疗会产生需要姑息治疗的情况。实现尽可能最佳的功能是处理头颈部肿瘤的主要考虑因素。言语、吞咽、口腔卫生和有异味的肿瘤方面的困难都很常见。“头颈部团队”也应以全面的方式解决抑郁症问题。外科医生、放射治疗师和肿瘤内科医生将需要牙医、修复牙医、口腔保健员、精神科医生、物理治疗师、职业和物理治疗师、访视护士、营养师和社会工作者的帮助。虽然医院中的姑息治疗通常不可避免，但却是最不理想的。适当的临终关怀支持将使患者及其家人受益。
