Integrating systemic agents into multimodality treatment of locally advanced head and neck cancer
Integrating systemic agents into multimodality treatment of locally advanced head and neck cancer
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DOI：
10.1093/annonc/mdq291
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发表时间：
2010-10-01
影响因子：
50.5
通讯作者：
Posner, M. R.
中科院分区：
文献类型：
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作者：
Posner, M. R.
尽管在20世纪80年代备受争议，但随机临床试验提供了不可否认的证据，表明全身化疗作为多模式治疗合作的一部分，可有效改善局部晚期头颈癌（HNC）的生存率，器官保护和局部区域控制。我们正在进入一个激动人心的时期，新的化疗药物，新的治疗模式，新的手术和放射技术，以及新的预后因素正在迅速成为可用。缺乏关于如何整合这些新工具以及它们如何影响长期结果的信息，这使得决策和治疗计划更加困难。随着HNC前所未有的生存率和不断变化的人口统计学，我们现在必须考虑长期的后果，除了生存和局部和区域控制作为治疗决策的重要因素。结合全身化疗、放疗和手术的不同治疗计划的可用性为我们提供了许多工具，可以为每个患者制定治疗方案。今天，在这个令人兴奋和混乱的时期，在决策和规划的开始为每个HNC患者提供多学科和协作的方法是必要的，也是卓越患者护理的绝对标准。
Although highly debated in the 1980s, randomized clinical trials have provided undeniable evidence that systemic chemotherapy, as part of a multimodality treatment collaboration, is effective in improving survival, organ preservation and local-regional control in locally advanced head and neck cancer (HNC). We are entering an exciting period in which new chemotherapy agents, new paradigms of treatment, new surgical and radiation technology, and new prognostic factors are rapidly becoming available. Information on how to integrate these new tools and on how they affect long-term outcomes are lacking, making decision making and treatment planning more difficult. With unprecedented survival and the changing demographics of HNC we must now consider long-term consequences in addition to survival and local and regional control as important factors in therapeutic decision making. The availability of different treatment plans that incorporate systemic chemotherapy, radiotherapy and surgery give us many tools with which to craft a treatment for each individual patient. Today, in this exciting and chaotic period, a multidisciplinary and collaborative approach for each HNC patient at the start of decision making and planning is a necessity and the absolute standard of medical treatment for excellent patient care.