Innovations in risk-stratification and treatment of Veterans with oropharynx cancer; roadmap of the 2019 Field Based Meeting.
Innovations in risk-stratification and treatment of Veterans with oropharynx cancer; roadmap of the 2019 Field Based Meeting.
复制标题
患有口咽癌的退伍军人的风险分层和治疗方面的创新；
DOI：
10.1016/j.oraloncology.2019.104440
复制
发表时间：
2020
期刊：
影响因子：
4.8
通讯作者：
Du
中科院分区：
文献类型：
--
作者：
Sandulache,VC;Lei,YL;Heasley,LE;Chang,M;Amos,CI;Sturgis,EM;Graboyes,E;Chiao,EY;Rogus-Pulia,N;Lewis,J;Madabhushi,A;Frederick,MJ;Sabichi,A;Ittmann,M;Yarbrough,WG;Chung,CH;Ferrarotto,R;Mai,Weiyuan;Skinner,HD;Du
来自全国各地医院和学术癌症中心以及退伍军人健康管理局的60多位思想领袖在贝勒医学院召开了一次高度互动的“现场会议”（FBM），重点关注口咽鳞状细胞癌（OPSCC）。与会者一致认为，OPSCC在美国，退伍军人群体构成了独特的挑战，由于较高的相对发病率和较差的治疗结果比在平民人口中观察到的。人乳头瘤病毒（HPV）相关的OPSCC相对于烟草相关的头颈癌具有更有利的结果，使生存率成为该人群的一个重要问题。然而，由于退伍军人人群的烟草使用率很高，有大量的“双重暴露”OPSCC患者在有显著烟草使用史的情况下患有HPV相关疾病。虽然这些患者的结局明显比非烟草使用者的HPV相关OPSCC更差，但关于这组患者预后和最佳治疗策略的许多细节尚不清楚。退伍军人人群中的高水平医疗合并症，以及许多退伍军人的社会支持不足，对该人群中OPSCC的治疗提出了额外的挑战。此外，很少有跨VA联盟来协调OPSCC退伍军人的多中心临床试验，VA系统中OPSCC的护理提供地点非常异质，并且在可用服务（例如放射肿瘤学）和支持研究和临床试验的基础设施方面差异很大。
Over 60 thought leaders from hospitals and academic cancer centers across the country and within the Veterans Health Administration convened at the Baylor College of Medicine for a highly interactive “Field-Based Meeting”(FBM) focused on oropharyngeal squamous cell carcinoma (OPSCC). Participants agreed that OPSCC in the US, the Veteran population poses unique challenges, due to higher relative incidence and poorer treatment outcomes than those observed in the civilian population. Human papillomavirus (HPV)-related OPSCC has more favorable outcome relative to tobacco-associated head and neck cancer, making survivorship a significant issue in this population. However, due to high rates of tobacco use in the Veteran population, there is a large cohort of “dual exposed” OPSCC patients who have HPV-related disease in the setting of a significant history of tobacco use. While these patients clearly have worse outcomes than non-tobacco users with HPV-related OPSCC, many details about prognosis and optimum treatment strategy in this group of patients are not known. The high level of medical comorbidities in the Veteran population, and poor social support for many Veterans pose additional challenges to treatment of OPSCC in this population. Furthermore, there are few cross-VA consortia to coordinate multi-center clinical trials for Veterans with OPSCC, and care delivery sites for OPSCC in the VA system are very heterogeneous and vary widely in terms of services available (eg radiation oncology) and infrastructure to support research and clinical trials.