Grau C, Specht L K, Hansen H S, Overgaard M, Overgaard J
Onkologisk afdeling, Arhus Universitetshospital, Arhus Kommunehospital.
Ugeskr Laeger. 1997 Feb 17;159(8):1104-8.
In a prospective study, the value of the clinical follow-up after treatment for head and neck cancer has been assessed. A total of 407 visits in 377 patients were recorded during a three month period in 1993 at the two major radiotherapy departments in Denmark. The results showed that 61% of follow-up visits included one or more problems either related to treatment morbidity or tumour recurrence. About 50% of all visits included treatment related normal tissue problems, and 30% had problems that required intervention. Although the majority of problems occurred within a few years after treatment, 47% of patients at three to four years observation time still had one or more problems. A total of 34 new tumour recurrences were found in the period, and of these 11 (32%) were asymptomatic. It is concluded that head and neck cancer patients have both tumour and normal tissue problems several years after the end of treatment. Since effective salvage treatment improves local control significantly, early detection of possible recurrence is important. A follow-up period of four to five years is recommended-preferably by qualified experts in the management of both recurrent disease and treatment morbidity.
在一项前瞻性研究中,对头颈部癌治疗后的临床随访价值进行了评估。1993年,在丹麦的两个主要放疗科室,对377例患者进行了为期三个月的随访,共记录了407次就诊情况。结果显示,61%的随访就诊包含一个或多个与治疗并发症或肿瘤复发相关的问题。约50%的就诊包含与治疗相关的正常组织问题,30%的就诊有需要干预的问题。尽管大多数问题发生在治疗后的几年内,但在三到四年的观察期内,47%的患者仍有一个或多个问题。在此期间共发现34例新的肿瘤复发,其中11例(32%)无症状。结论是,头颈部癌患者在治疗结束数年后仍存在肿瘤和正常组织问题。由于有效的挽救性治疗能显著提高局部控制率,因此早期发现可能的复发很重要。建议进行四到五年的随访,最好由处理复发性疾病和治疗并发症的合格专家进行。