Radiotherapy for the management of locally advanced squamous cell carcinoma of the head and neck.
Radiotherapy for the management of locally advanced squamous cell carcinoma of the head and neck.
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DOI：
10.1111/j.1601-0825.2008.01495.x
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发表时间：
2009-03
期刊：
影响因子：
3.8
通讯作者：
Citrin D
中科院分区：
文献类型：
--
作者：
Ko C;Citrin D
在美国，头颈部鳞状细胞癌(SCCHN)每年影响大约35,000人。虽然随着治疗的进步，生存率有所提高，但晚期SCCHN患者的预后仍然很差。了解治疗选择的基本原理、治疗的最新进展和治疗毒性是至关重要的。对局部晚期SCCHN的标准治疗方法进行了综述。讨论了医学和放射治疗管理的进展，并描述了治疗的毒性。术后放化疗用于具有高危特征的患者。诱导化疗和改变分割放射治疗已被评估为确定的化疗-放射治疗的替代方案。靶向药物，如西妥昔单抗，可能会在毒性增加最小的情况下提高存活率。诸如调强放射治疗(IMRT)的使用等技术改进已被证明可以减少放射治疗的一些衰弱副作用。局部进展型SCCHN仍是一个治疗挑战。生存、局部控制和生活质量都是治疗的目标。治疗局部晚期SCCHN的最佳方法是正在进行的研究主题。通过使用较新的技术和仔细的治疗计划，可以最大限度地减少长期副作用。
Squamous cell carcinomas of the head and neck (SCCHN) affect approximately 35,000 people in the United States yearly. Although survival has improved with advances in therapy, patients with advanced stages of SCCHN continue to have a poor prognosis. An understanding of rationale for treatment selection, newer developments in therapy, and treatment toxicity is critical. Standard methods of treating locally advanced SCCHN are reviewed. Advances in medical and radiotherapeutic management are discussed and the toxicities of therapy are described. Post-operative chemoradiation is used in patients with high risk characteristics. Induction chemotherapy and altered fractionation radiation treatment have been evaluated as alternatives to definitive chemo-radiotherapy. Targeted agents such as cetuximab may prove to increase survival with minimal increase in toxicity profile. Technological improvements such as the use of intensity modulated radiation treatment (IMRT) have proven to decrease some debilitating side effects from radiation treatment. Locally advanced SCCHN continues to present a therapeutic challenge. Survival, local control, and quality of life are all goals of treatment. The optimal method of treating locally advanced SCCHN is the subject of ongoing research. Long term side effects can be minimized with the use of newer technologies and with careful treatment planning.
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