Documentation and incidence of late effects and screening recommendations for adolescent and young adult head and neck cancer survivors treated with radiotherapy
Documentation and incidence of late effects and screening recommendations for adolescent and young adult head and neck cancer survivors treated with radiotherapy
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DOI：
10.1007/s00520-018-4559-5
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发表时间：
2019-07-01
影响因子：
3.1
通讯作者：
Goddard, Karen
中科院分区：
文献类型：
--
作者：
Hamilton, Sarah Nicole;Arshad, Omair;Goddard, Karen
目的：对不列颠哥伦比亚省癌症中心接受放射治疗的青少年和年轻成人（AYA）头颈癌（HNC）患者进行回顾性分析，以确定晚期毒性的发生率，讨论了记录的晚期副作用，并在将护理转移给初级保健提供者（PCP）时提供了筛查建议。回顾了1960年至2010年诊断为HNC并接受RT治疗的所有15至35岁患者，这些患者在诊断后存活> 5年。结果85%的患者在初次咨询时记录了关于长期副作用风险的讨论。大多数患者（78%）发生>1例记录的晚期效应。最常见的是口干（44%）、皮肤变化（28%）、颈部纤维化（22%）、鼻结痂（16%）、鼻出血（16%）和龋齿（14%）。总的来说，20%的人目前正在接受随访或一直随访到他们去世。在80%转到PCP的患者中，14%有正式的出院总结。对于那些从不列颠哥伦比亚省癌症出院的患者，记录的建议包括定期牙科护理（34%）和甲状腺功能减退症（5%）和第二恶性肿瘤（4%）的筛查。大多数PCP没有被发送出院总结，概述延迟迟发效应的筛查建议。晚期效应的高风险，并将受益于生存护理计划概述这些风险和筛查建议。
PurposeA retrospective review of adolescent and young adult (AYA) head and neck cancer (HNC) patients treated with radiation therapy (RT) at British Columbia Cancer was performed to determine the incidence of late toxicities, the documented late side effects discussed and the screening recommendations provided at the time of transfer of care to primary care providers (PCPs).MethodsCharts (n=162) were reviewed for all patients 15 to 35years at diagnosis with HNC treated with RT from 1960 to 2010 who survived >5years after diagnosis.ResultsA discussion regarding the risk of long-term side effects was documented in the initial consultation for 85% of patients. The majority of patients (78%) developed >1 documented late effect. The most common were xerostomia (44%), skin changes (28%), neck fibrosis (22%), nasal crusting (16%), epistaxis (16%), and dental decay (14%). In all, 20% were currently followed or were followed until they died. Of the 80% transferred to their PCP, 14% had a formal discharge summary. For those discharged from British Columbia Cancer, documented recommendations included regular dental care (34%) and screening for hypothyroidism (5%) and second malignancy (4%).ConclusionsThe majority of AYA HNC patients treated with RT developed late side effects, and most PCPs were not sent a discharge summary outlining screening recommendations for delayed late effects.Implications for cancer survivorsAYA HNC survivors treated with RT are at high risk for late effects and would benefit from a survivorship care plan outlining these risks and screening recommendations.