Quality of dying in head and neck cancer patients: the role of surgical palliation
Quality of dying in head and neck cancer patients: the role of surgical palliation
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DOI：
10.1007/s00405-012-2059-7
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发表时间：
2013-02-01
影响因子：
2.6
通讯作者：
Wei, William Ignace
中科院分区：
文献类型：
--
作者：
Chan, Jimmy Yu Wai;To, Victor Shing Howe;Wei, William Ignace
研究手术对晚期头颈恶性肿瘤患者症状缓解的作用。 2000年至2011年间，对选择手术姑息治疗来控制症状的头颈部局部晚期癌症患者进行了回顾性研究。研究期间，共纳入 52 名患者。指标肿瘤包括上颌癌（23.1%）、舌癌（19.2%）、喉/下咽癌（15.4%）、放射后肉瘤（11.5%）、原发性肉瘤（11.5%）、下牙槽癌（11.5%）、鼻粘膜黑色素瘤（3.9%）和头颈部转移性肿瘤地区（3.9%）。主要症状包括出血（53.9%）、瘤痛（19.2%）、吞咽困难（11.5%）、溃疡不愈（7.7%）、气道阻塞（5.8%）和下颌骨病理性骨折（1.9%）。 10 名患者进行了颈动脉结扎，35 名患者进行了肿瘤完整切除，7 名患者进行了肿瘤减灭术。患者的平均生存期为 5.6 个月。大多数患者的症状得到了满意且持续的控制。一名患者在住院期间死于肺炎，其余患者平均住院时间16.4天后出院。对于选定的患者，手术可以有效缓解难以控制的症状。详细的计划和良好的沟通是提高染色质量成功的关键。
To study the role of surgery for symptom palliation in patients with advanced head and neck malignancy. Between 2000 and 2011, patients with locoregionally advanced cancer in the head and neck region, who chose surgical palliation for symptom control, were studied retrospectively. During the study period, 52 patients were included. The index tumour included carcinoma of the maxilla (23.1 %), tongue (19.2 %), larynx/hypopharynx (15.4 %), post-radiation sarcoma (11.5 %), primary sarcoma (11.5 %), carcinoma of the lower alveolus (11.5 %), nasal mucosal melanoma (3.9 %) and metastatic tumour in the head and neck region (3.9 %). The major symptoms included bleeding (53.9 %), tumour pain (19.2 %), dysphagia (11.5 %), non-healing ulcerations (7.7 %), airway obstruction (5.8 %) and pathological fracture of the mandible (1.9 %). Ligation of the carotid artery was performed in 10 patients, complete resection of tumour in 35, and surgical debulking of the tumour in 7 patients. Mean survival of the patients was 5.6 months. The majority of the patients achieved satisfactory and persistent control of symptoms. One patient died from pneumonia during the hospital stay, and the rest were discharged after a mean duration of 16.4 days. In selected patients, surgery is effective in palliating symptoms which are otherwise difficult to manage. Detailed planning and good communication is the key to success in improving the quality of dying.