周全性老年评估在老年头颈癌患者中的应用

doi:10.13591/j.cnki.kqyx.2024.08.013

摘要/Abstract

摘要：

头颈癌的治疗以手术和放化疗为主,但临床上对老年患者实施侵入性治疗的合理性还存在质疑。尽管老年头颈癌患者的比例逐步增加,却几乎没有一致的治疗标准。本文从循证医学角度呈现当前治疗的证据水平,为老年头颈癌患者提供具体的治疗建议,并基于对文献的系统评价提出一种算法用以评估老年头颈癌患者的治疗风险。

关键词: 头颈癌, 高龄, 合并症, 老年评估, 循证算法

Abstract:

The treatment of head and neck cancer is dominated by surgery and radiochemotherapy. For elderly patients, however, the rationality of invasive treatment is questioned in clinical practice. Although the proportion of geriatric patients with head and neck cancer is increasing, there are few consistent standards in the literature and guidelines. From the perspective of evidence-based medicine, this paper presents current evidence for treatment so as to provide specific recommendations for treating head and neck cancer in the elderly. Furthermore, based on a systematic literature review, a clinical algorithm is proposed to evaluate the treatment risk of elderly patients with head and neck cancer.

Key words: head and neck cancer, elderly, comorbidity, geriatric assessment, algorithm

中图分类号:

R739.8

李晨曦, 龚忠诚, 赵化荣, 刘英. 周全性老年评估在老年头颈癌患者中的应用[J]. 口腔医学, 2024, 44(8): 630-634.

LI Chenxi, GONG Zhongcheng, ZHAO Huarong, LIU Ying. The application of comprehensive geriatric assessment in elderly patients with head and neck cancer[J]. Stomatology, 2024, 44(8): 630-634.

图/表 2

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参考文献 37

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疾病种类	疾病名称
循环系统疾病	冠心病、心肌梗死、瓣膜性心脏病、充血性心力衰竭、心律不齐、高血压、周围血管阻塞性疾病等
造血系统疾病	贫血、血细胞增生异常、凝血异常、淋巴系统疾病、肿瘤等
呼吸系统疾病	肺结核、肺气肿、慢性支气管炎、哮喘、肺炎、慢性阻塞性肺病、尘肺病、肿瘤等
眼耳鼻喉口腔疾病	白内障、青光眼、黄斑退化、视神经萎缩、视网膜病变、牙周病、牙体缺损、牙列缺损、失聪、眩晕、良性肿瘤、恶性肿瘤等
上消化道疾病	胃炎、溃疡、出血、功能性障碍、良性肿瘤、恶性肿瘤等
下消化道疾病	出血、痔疮、大便失禁、良性肿瘤、恶性肿瘤等
肝胆胰疾病	急性肝炎、脂肪肝、急性重症肝炎、肝硬化、慢性病毒性肝炎、胆结石、胰腺炎、良性肿瘤、恶性肿瘤等
肾脏疾病	肾小球炎、感染、肾结石、慢性肾功能不全、良性肿瘤、恶性肿瘤、肾衰竭包括血液透析等
泌尿生殖系统疾病	前列腺肥大、尿失禁、阴道炎、良性肿瘤、恶性肿瘤等
皮肤、肌肉、骨骼疾病	关节炎、痛风、骨折、肌腱或其他软组织炎、骨质疏松等
神经系统疾病	脑卒中(梗死或出血)、帕金森病、外伤、癫痫、良性肿瘤、恶性肿瘤等
内分泌与代谢疾病	单纯糖尿病无并发症,糖尿病合并有视网膜病变、肾脏病变或是周围神经病变,甲亢或甲减,高脂血症,绝经综合征等
情绪与行为问题	痴呆、抑郁症、精神分裂症、妄想症、谵妄