晚期头颈肿瘤的综合序列治疗与头颈肿瘤内科

目前,晚期头颈肿瘤的5年生存率在30%左右,对晚期头颈肿瘤需采用综合序列治疗。肿瘤综合治疗(combined treatment)的概念在上世纪50～60年代即被提出,主要是指手术与放疗的结合。20世纪70年代化疗在头颈肿瘤治疗中的地位被正式确认,并被公认为与外科及放射治疗一起成为"正规"的     

正确把握头颈鳞状细胞癌临床治疗和研究的发展方向

头颈鳞状细胞癌(简称鳞癌)占人体肿瘤发病的第6位,具有致残率和致死率高的特性[1].虽然各项诊断治疗策略和技术在不断发展进步,但这类肿瘤的5年总体生存率并未得到明显提高.对于不同部位的头颈鳞癌,外科手术治疗的技术不断成熟,部分患者从中获益;综合与辅助治疗的策略不断涌现,单独应用或与外科手术结合能够提高肿瘤的控制率,多学科协作治疗头颈鳞癌是当前的主要发展趋势.虽然早期患者较中晚期患者的治疗效果和预后好,但由于解剖因素和患者自我关注的意识差,多数头颈鳞癌患者就诊时已经属于中晚期.不管采取的治疗措施如何,治疗后复发和转移,仍然是影响头颈鳞癌预后的最主要因素,头颈鳞癌的早期诊断和预警以及肿瘤对常规辅助与综合治疗(如放化疗和分子靶向治疗等)的抵抗和不敏感仍然是这类肿瘤治疗中尚未彻底解决的实际问题.所以如何正确把握头颈鳞癌临床治疗和研究的发展方向,是解决上述问题的关键所在,总结起来具体可从以下几个方面加以把握和入手.     

头颈外科微创和综合治疗进展学习班通知

经国家继续教育委员会批准,首都医科大学附属北京同仁医院耳鼻咽喉头颈外科拟举办"头颈外科微创和综合治疗进展学习班",届时将以新版学术专著《同仁头颈外科诊疗手册》(人民卫生出版社,韩德民、房居高教授主编,国内权威专家集体编写)作为主要教材之一,并邀请北京地区知名头颈外科专家做专题报告。授课内容主要从头颈肿瘤的诊疗规范、治疗进展等     

头颈肿瘤远处转移的诊疗新进展

远处转移是影响头颈肿瘤患者预后的重要原因.尽管近年来在肿瘤治疗上取得了显著的进步,头颈肿瘤远处转移的治疗仍然十分不理想.对头颈肿瘤医生来说,头颈部恶性肿瘤远处转移的临床诊断、治疗仍然是一个非常重要的问题.本文对目前头颈肿瘤远处转移的相关影响因素、发生部位以及临床筛查、治疗方面的近期研究结果进行回顾.     

头颈肿瘤化疗回顾与进展

由于头颈解剖部位的特殊性,导致手术和放射治疗受限,化疗常是中晚期头颈肿瘤的综合治疗中的一部分,有关化疗在头颈肿瘤治疗中的价值一直存在争议,现回顾国内外化疗在头颈肿瘤治疗中的疗效并对近来的研究进展进行综述。     

头颈肿瘤化疗回顾与进展

由于头颈解剖部位的特殊性，导致手术和放射治疗受限，化疗常是中晚期头颈肿瘤的综合治疗中的一部分，有关化疗在头颈肿瘤治疗中的价值一直存在争议，现回顾国内外化疗在头颈肿瘤治疗中的疗效并对近来的研究进展进行综述。     

头颈外科微创和综合治疗进展学习班通知

经国家继续教育委员会批准,首都医科大学附属北京同仁医院耳鼻咽喉头颈外科拟举办"头颈外科微创和综合治疗进展学习班",届时将以新版学术专著《同仁头颈外科诊疗手册》(人民卫生出版社,韩德民、房居高教授主编,国内权威专家集体编写)作为主要教材之一,并邀请北京地区知名头颈外科专家做专题报告。授课内容主要从头颈肿瘤的诊疗规范、治疗进展等多层面展开,包括新技术、新进展、热点与有争议的难点问题,并进行现场手术观摩,具有权威性和实用性的特点。     

国家级继续教育项目头颈肿瘤器官功能保全性治疗专题研讨班通知

为普及头颈肿瘤功能保全性治疗的新技术,规范头颈肿瘤治疗程序,我院将于2012年6月29日～7月2日在湖南长沙举办国家级继续医学教育项目"头颈肿瘤器官功能保全性治疗专题"研讨班。届时将邀请国     

学术动态

中华医学会耳鼻咽喉头颈外科肿瘤学术会议征稿通知中华医学会耳鼻咽喉头颈外科学分会和中华医学会学术部定于2006年11月3—6日在桂林召开“中华医学会耳鼻咽喉头颈外科肿瘤学术会议”。会议就本学科领域内有关临床、基础等科研成果及经验举办专题讲座及进行交流讨论。征文內容为有关头颈肿瘤的基础研究、预防、治疗及康复的新成果及进展。征文要求:①论文未在国内外公开发表;②提交800字左右的论文摘要;③论文提交方式:用Word文档以附件形式发送至2006headneck@trhos.com;或用软盘寄至:北京东城区东交民巷1号北京同仁医院耳鼻咽喉头颈外科,…     

消息

头颈外科微创和综合治疗进展学习班通知经国家继续教育委员会批准,首都医科大学附属北京同仁医院耳鼻咽喉头颈外科拟举办"头颈外科微创和综合治疗进展学习班",届时将以新版学术专著《同仁头颈外科诊疗手册》(人民卫生出版社,韩德民、房居高教授主编,国内权威专家集体     

"Mini-rhinoplasty"

OBJECTIVES: To define the interest of the so called "mini-rhinoplasty" in aesthetic nose surgery and to report the surgical technique. METHOD: The experience of the authors, based on more than 500 mini-rhinoplasty surgical procedures is reported. The surgical procedure such as technical tips are reported. RESULTS: Mini-rhinoplasty procedure is indicated in patients with small deformities, particularly in patients with nasal hump or hyper-projected noses, with no deviation. The nasal tip should be normal or slightly drooping. The surgical technique is safe and reproducible. Surgical aesthetic outcomes are excellent. This technique is also indicated in elderly patients willing a facial rejuvenation. CONCLUSION: Mini-rhinoplasty surgical technique is a minimal invasive procedure with no complication in the postoperative period. The postoperative management of patients undergoing this procedure is of main importance.     

What makes "Head-and-Neck-Cancers" recur: Tumorinvasion "revisited"

Head and neck squamous cell carcinomas (HNSCC) are common cancers with a relatively poor prognosis. Locoregionale recurrences are regularly encountered and associated with a detrimental outcome. Studies of the last few years report that not only tumor staging and grading influence locoregional control but also histologic and biological markers. One such histological marker is coined "worst pattern of invasion". It describes a histologic growth pattern consisting of invading tumor cell islands and strands that are dispatched from the invasion front (POI typ 4 and 5). Additional features of invasion are perineural invasion and extracapsular nodal extension. Besides histological markers there are molecular characteristics that include the expression of gene families involved in extracellular matrix degradation. The data suggest that head and neck cancers differ with respect to their invasive growth capacity and thus their ability to generate locoregionale recurrences. It appears that locoregionale control is a consequence of this growth pattern. This may explain, why in recent clincial studies the prognostic marker "pattern-of-invasion" outweights even such well established prognosticators such as "surgical margins".     

Dynamic visual acuity using "far" and "near" targets

CONCLUSIONS: DVA may be useful for assessing the functional consequences of an impaired gaze stabilization mechanism or for testing the effectiveness of a rehabilitation paradigm. Because target distance influences the relative contributions of canal and otolith inputs, the ability to measure DVA at near and far viewing distances may also lead to tests that will independently assess canal and otolith function. OBJECTIVE: To present and test a methodology that uses dynamic visual acuity (DVA) to assess the efficacy of compensatory gaze mechanisms during a functionally relevant activity that differentially measures canal and otolith function. MATERIAL AND METHODS: The effect of treadmill walking at a velocity of 1.79 m/s on subjects' visual acuity was assessed at each of two viewing distances. A custom-written threshold determination program was used to display Landolt C optotypes on a laptop computer screen during a "far" (4 m) target condition and on a micro-display for a "near" (50 cm) target condition. The walking acuity scores for each target distance were normalized by subtracting a corresponding acuity measure obtained while standing still on the treadmill belt. RESULTS: As predicted by subjective reports of relative target motion, the decrease in visual acuity was significantly greater (p < 0.00001) for the near compared to the far condition.