Algorithms of follow-up in patients with head and neck cancer in relation to primary location and advancement. Consensus of Polish ENT Society Board and Head Neck Experts

被引:1
|
作者
Wierzbicka, Malgorzata [1 ,2 ,3 ]
Markowski, Jaroslaw [4 ]
Pietruszewska, Wioletta [5 ]
Burduk, Pawel [6 ]
Mikaszewski, Boguslaw [7 ]
Rogowski, Marek [8 ]
Skladowski, Krzysztof [9 ]
Milecki, Piotr [10 ]
Fijuth, Jacek [11 ]
Jurkiewicz, Dariusz [12 ]
Niemczyk, Kazimierz [13 ]
Maciejczyk, Adam [14 ]
机构
[1] Reg Specialist Hosp Wroclaw, Res & Dev Ctr, Dept Otolaryngol, Wroclaw, Poland
[2] Wroclaw Univ Sci & Technol, Fac Med, Wroclaw, Poland
[3] Polish Acad Sci, Inst Human Genet, Poznan, Poland
[4] Med Univ Silesia, Fac Med Sci Katowice, Dept Laryngol, Katowice, Poland
[5] Med Univ Lodz, Dept Otolaryngol Head & Neck Oncol, Lodz, Poland
[6] Nicolaus Copernicus Univ Torun, Dept Otolaryngol Phoniatr & Audiol, Bydgoszcz, Poland
[7] Med Univ Gdansk, Fac Med, Dept Otolaryngol, Gdansk, Poland
[8] Med Univ Bialystok, Dept Otolaryngol, Bialystok, Poland
[9] Mar Skłodowska Curie Natl Res Inst Oncol, Radiat & Clin Oncol Dept, Gliwice Branch, Gliwice, Poland
[10] Greater Poland Canc Ctr, Dept Radiotherapy 1, Poznan, Poland
[11] Med Univ Lodz, Oncol Chair, Dept Radiat Therapy, Lodz, Poland
[12] Natl Res Inst, Mil Inst Med, Dept Otolaryngol & Laryngol Oncol, Clin Dept Cranio Maxillofacial Surg, Warsaw, Poland
[13] Med Univ Warsaw, Dept Otorhinolaryngol Head & Neck Surg, Warsaw, Poland
[14] Wroclaw Med Univ, Dept Oncol, Wroclaw, Poland
来源
FRONTIERS IN ONCOLOGY | 2023年 / 13卷
关键词
algorithm; head and neck cancer; follow-up; salvage; risk of failure; primary location; advancement; SQUAMOUS-CELL CARCINOMA; RECURRENT NASOPHARYNGEAL CARCINOMA; SALVAGE SURGERY; PLEOMORPHIC ADENOMA; CURATIVE TREATMENT; PRIMARY TUMORS; ORAL-CAVITY; SURVEILLANCE; LARYNGEAL; HYPOPHARYNX;
D O I
10.3389/fonc.2023.1298541
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The algorithm of follow-up in patients with head and neck cancer (HNC) has been prepared by a board of Polish Head Neck and Oncology Experts. The aim of this research is to focus on the specificity of HNC monitoring, to review the current trends in follow-up, and to adapt the evidence-based medicine international standards to the capabilities of the local healthcare service. Materials and methods: The first methodological step was to categorize HNCs according to the estimated risk of failure after the adequate first-line treatment and according to the possibility of effective salvage treatment, resulting in improved overall survival. The final method used in this work was to prepare an authors' original monitoring algorithm for HNC groups with a high, moderate, and low risk of recurrence in combination with a high or low probability of using an effective salvage. Results: Four categories were established: Ia. low risk of recurrence + effective organ preservation feasible; Ib. low risk of recurrence + effective salvage feasible; II. moderate risk of recurrence + effective salvage feasible; III. high risk of recurrence + effective salvage feasible; and IV. high risk of recurrence + no effective salvage feasible. Follow-up visit consisting of 1. ENT examination + neck ultrasound, 2. imaging HN tests, 3. chest imaging, 4. blood tests, and 5. rehabilitation (speech and swallowing) was scheduled with a very different frequency, at the proposed monthly intervals, tailored to the needs of the group. The number of visits for individual groups varies from 1 to 8 in the first 2 years and from 1 to 17 in the entire 5-year monitoring period. Group IV has not been included in regular follow-up, visits on own initiative of the patient if symptomatic, or supportive care needs, having in mind that third-line therapy and immune checkpoint inhibitors are available. Conclusion: Universal monitoring algorithm for HNC four groups with a high, moderate, and low risk of recurrence after the adequate treatment in combination with a high or low probability of using an effective salvage is an innovative approach to redeploying system resources and ensuring maximum benefit for patients with HNC.
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页数:14
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