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Diagnosis and management of head and neck cancer

Tham khảo sách 'diagnosis and management of head and neck cancer', y tế - sức khoẻ, y dược phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | SI GN Scottish Intercollegiate Guidelines Network NHS Quality Improvement Scotland Diagnosis and management of head and neck 90 cancer A national clinical guideline 1 Introduction 1 2 Presentation screening and risk factors 3 3 Referral and diagnosis 6 4 Histopathology reporting 10 5 Overview of treatment of the primary tumour and neck 12 6 Treatment radiotherapy as the major treatment modality 17 7 Treatment surgery as the major treatment modality 22 8 Treatment chemotherapy in combination with surgery or radiotherapy 25 9 Treatment management of locoregional recurrence 28 10 Treatment palliation of incurable disease 30 11 Laryngeal cancer 32 12 Hypopharyngeal cancer 36 13 Oropharyngeal cancer 39 14 Oral cavity cancer 43 15 Follow up rehabilitation and patient support 47 16 Information for discussion with patients and carers 53 17 Implementation resource implications audit and further research 63 18 Development of the guideline 65 Abbreviations 68 Annexes 70 References 78 October 2006 COPIES OF ALL SIGN GUIDELINES ARE AVAILABLE ONLINE AT WWW.SIGN.AC.uk KEY TO EVIDENCE STATEMENTS AND GRADES OF RECOMMENDATIONS LEVELS OF EVIDENCE 1 High quality meta-analyses systematic reviews of randomised controlled trials RCTs or RCTs with a very low risk of bias 1 Well conducted meta-analyses systematic reviews of RCTs or RCTs with a low risk of bias 1 - Meta-analyses systematic reviews of RCTs or RCTs with a high risk of bias 2 High quality systematic reviews of case control or cohort studies High quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal 2 Well conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal 2 - Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal 3 Non-analytic studies eg case reports case series 4 Expert opinion .