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題名 | 研擬適切的頭頸癌患者治療後追蹤計畫=The Optimal Post-therapeutic Surveillance Schedule for Head and Neck Cancers |
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作者 | 呂宜興; 張珮涵; 李佩怡; 劉景萍; Leu, Yi-shing; Chang, Pei-han; Lee, Pei-yi; Liu, Ching-ping; |
期刊 | 臺灣癌症醫學雜誌 |
出版日期 | 20150600 |
卷期 | 2:2 2015.06[民104.06] |
頁次 | 頁127-131 |
分類號 | 416.21 |
語文 | chi |
關鍵詞 | 頭頸癌; 追蹤; 治療; Head and neck cancer; Surveillance; Treatment; |
中文摘要 | 頭頸部癌症為惡性腫瘤侵犯範圍很廣,包括唇、鼻腔副鼻竇、口腔、口咽、下咽、 喉部及唾液腺。頭頸癌的治療方式有手術、放射治療、化學治療,可能單獨執行或是合 併依序進行,不同醫師、不同醫學中心、甚至不同國家,因為民情或健康保險不同,衍 生出部分不同治療及追蹤的方式。回顧所有各國治療指引及文獻,如果要發展出一套治 療後追縱方式(one size fits all),適合頭頸癌所有期別病患,基本上十分困難。 本院頭頸癌追蹤計畫在完成治療指引中的療程後,第一年期間,建議每月回診一次 以上;如果多科治療團隊則考慮穿插,但是前 6 個月,建議所屬科別每月回診一次。第 2-3 年期間,建議每 2 個月回診。第 4-5 年期間,建議每 3 個月回診。第 5 年後,建議 每 6 個月回診。患者在追蹤前三年後每年重覆執行治療前的檢查項目,以利評估後續治 療計畫。但是如有懷疑復發或是有遠處轉移現象,宜增加回診次數及檢查項目強度。完 整治療後前三年宜定期回診;超過五年則鼓勵患者以症狀為主作自我管理。目前國際上 對於頭頸癌治療後的追蹤計畫並無一致的共識,不過依照病患分期及疾病嚴重度,由多 專科團隊醫師們共同決定為宜。本文整理各國治療指引中的追蹤計畫及相關文獻,提出 綜合分析。 |
英文摘要 | Head and neck cancers encompass malignancies in the nasal cavity, paranasal sinuses, oral cavity, oropharynx, larynx, hypopharynx, and salivary gland. The mainstay treatments are surgery, radiotherapy and chemotherapy in single modality or sequential settings. The surveillance of head and neck cancer patients varies among individuals, medical centers, and even countries. By reviewing the clinical guidelines and pertinent medical literature, we attempted to determine the optimal surveillance schedule for all stages of disease. At our hospital, the surveillance schedule for head and neck cancer patients after complete treatment comprises of monthly follow-up in the first year by a multidisciplinary team, bi-monthly in the second and third years, tri-monthly in the fourth and fifth years, and semiannually thereafter. A complete cancer workup is performed annually in the first 3 years. Increasing frequencies or changes in diagnostic tools are suggested if there is any evidence of recurrence or metastasis. The follow-up principle in the first 3 years is on-schedule, and gradually shifts to symptom-oriented 5 years after treatment if there is no evidence of recurrence. The optimal post-therapeutic surveillance schedule for head and neck cancers should be set by a multidisciplinary team based on disease severity and staging. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。