晚期或复发性口腔(口咽)癌的救治性外科治疗中国专家共识  

Chinese expert consensus on salvage surgery for advanced or recurrent oral(oropharyngeal)cancers

作　　者：何悦[1] 祝奉硕 马春跃[1] 贺捷[1] 王延安[1] 李劲松[2] 刘冰 蒋灿华[4] 侯劲松[5] 彭歆[6] 何培杰 张东升 王军[9] 刘习强 杨宏宇[11] 陈超刚[12] 吴逸群[13] 姚原 苏立新[15] 刘峰[16] 马玉波[17] 朱凌[18] 温红梅[19] 黄秋雨[5] HE Yue;ZHU Feng-shuo;MA Chun-yue;HE Jie;WANG Yan-an;LI Jin-song;LIU Bing;JIANG Can-hua;HOU Jin-song;PENG Xin;HE Pei-jie;ZHANG Dong-sheng;WANG Jun;LIU Xi-qiang;YANG Hong-yu;CHEN Chao-gang;WU Yi-qun;YAO Yuan;SU Li-xin;LIU Feng;MA Yu-bo;ZHU Ling;WEN Hong-mei;HUANG Qiu-yu(Department of Oromaxillofacial Head and Neck 0neology,Shanghai Ninth People's Hospital,Shanghai jiao Tong University School of Medicine,College of Stomatology,Shanghai jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology.Shanghai 200011;Department of Oral and Maxillofacial Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University.Guangzhou 510120,Guangdong Province;Department of Oral and Maxillofacial Surgery,Hospital of Stomatology,Wuhan University.Wuhan 430070,Hubei Province;Department of Oral and Maxillofacial Surgery,Xiangya Hospital Central South University.Changsha 410008,Hunan Province;Department of Oral and Maxillofacial Surgery,Guanghua School of Stomatology,Hospital of Stomatology,Sun Yat-sen University.Guangzhou 510055,Guangdong Province;Department of Oral and Maxillofacial Surgery,Peking University Hospital of Stomatology.Beijing 10008l;Department of ENT,The Eye and ENT Hospital of Fudan University.Shanghai 200031;Department of Oral and Maxillofacial Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University.Jinan 250021,Shandong Province;Department of Head and Neck Oncology,Gansu Provincial Cancer Hospital.Lanzhou 730050,Gansu Province;Department of Stomatology,Nanfang Hospital,Southern Medical University.Guangzhou 510515,Guangdong Province;Department of Oral and Maxillofacial Surgery,Peking University Shenzhen Hospital.Shenzhen 518036,Guangdong Province;Department of Clinical Nutrition,Sun Yat-sen Memorial Hospital,Sun Yat-sen University.Guangzhou 510120,Guangdong Province;Department of Neurosurgery,Shanghai Ninth People's Hospital,Shanghai jiao Tong University School of Medi

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011 [2]中山大学孙逸仙纪念医院口腔颌面外科,广东广州510120 [3]武汉大学口腔医院口腔颌面外科,湖北武汉430070 [4]中南大学湘雅医院口腔颌面外科,湖南长沙410008 [5]中山大学光华口腔医学院附属口腔医院口腔颌面外科,广东广州510055 [6]北京大学口腔医院口腔颌面外科,北京100081 [7]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031 [8]山东第一医科大学附属省立医院口腔颌面外科,山东济南250021 [9]甘肃省肿瘤医院头颈二科,甘肃兰州730050 [10]南方医科大学南方医院口腔科,广东广州510515 [11]北京大学深圳医院口腔颌面外科,广东深圳518036 [12]中山大学孙逸仙纪念医院临床营养科,广东广州510120 [13]上海交通大学医学院附属第九人民医院神经外科,上海200011 [14]上海交通大学医学院附属第九人民医院放射科,上海200011 [15]上海交通大学医学院附属第九人民医院介入科,上海200011 [16]上海交通大学医学院附属第九人民医院肿瘤科,上海200011 [17]上海交通大学医学院附属第九人民医院核医学科,上海200011 [18]上海交通大学医学院附属第九人民医院影像科,上海200011 [19]中山大学附属第三医院康复医学科,广东广州510630

出　　处：《中国口腔颌面外科杂志》2024年第6期521-528,共8页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市科学技术委员会“科技创新行动计划”(21Y11903700);口腔颌面外科学系研究助力基金(系2022-06)。

摘　　要：口腔(口咽)癌是头颈部恶性肿瘤中发生率最高的一种类型,相当数量的患者就诊时已为临床晚期,多需外科结合放化疗等综合手段治疗。许多患者在接受首次外科或放化疗后,会出现局部复发或转移,再次治疗更为困难,且预后不良。如何合理有效地治疗这些晚期或复发性口腔(口咽)癌患者已成为临床关注的焦点,然而针对如何开展救治性外科治疗,尚无依据可循,非规范诊疗也比较常见。本文整合现有循证医学证据,同时经全国口腔颌面头颈外科领域专家研讨商议,在晚期或复发性口腔(口咽)癌救治性外科治疗的定义、适应证、围术期评估、手术分级、辅助治疗、功能康复等领域达成共识,供全国口腔颌面外科及头颈外科医师参考。Oral(oropharyngeal)cancer is a type of malignant tumors of the head and neck with the highest incidence.Many patients have been clinically advanced,and most of them need to be treated by surgery combined with radiotherapy and chemotherapy.Many patients with oral(oropharyngeal)cancer will have local recurrence or metastasis after the first surgical or chemoradiotherapy,and the second treatment is more difficult with the poor prognosis.How to effectively treat these patients with advanced or recurrent oral(oropharyngeal)cancer has become the focus of clinical attention.However,there is no basis to follow about how to carry out therapeutic surgical treatment,and non-standard diagnosis and treatment are also common.Therefore,we formulated this consensus in the fields of definition,indications,perioperative evaluation,surgical classification,adjuvant therapy,functional rehabilitation and other fields of advanced or recurrent oral(oropharyngeal)cancer,based on evidence-based medical evidence and national maxillofacial head and neck surgery expert suggestion,for reference by oral and maxillofacial,and head&neck surgeons across the country.

关 键 词：口腔癌 口咽癌 救治性外科 专家共识 

分 类 号：R739.8[医药卫生—肿瘤]