MALIGNI TUMORI GLAVE I VRATA – ZNAČAJ ZA PRIMARNU ZDRAVSTVENU ZAŠTITU
Ključne reči:
maligni tumori, glava, vrat, faktori rizika, dijagnostikaApstrakt
Maligni tumori glave i vrata čine oko 5% - 8% svih malignih tumora u Evropi i Sjedinjenim Američkim državama. Veliki broj socijalnih, faktora ponašanja i faktora životne sredine povećava rizik nastanka tumora na glavi i vratu. Malo se zna o uzrocima nastanka, pa i mogućnostima prevencije tumora dece.Neki maligniteti se javljaju kod dece sa urođenim ili stečenim imunodeficijencijama. Kod dece, najučestaliji su limfomi i sarkomi. Simptomi i znaci malignih tumora glave i vrata su raznovrsni, u zavisnosti od anatomske lokalizacije i stepena proširenosti tumora. U oko 50 % slučajeva na početku lečenja prisutne su metastaze u limfnim čvorovima vrata, a u oko 5 % slučajeva i udaljene metastaze u plućima jetri, kostima i mozgu. U dijagnostici tumora glave i vrata veoma je važno pažljivo uzeti detaljnu anamnezu. Fizikalni pregled treba započeti inspekcijom i palapacijom vrata. Pregled sva tri sprata ždrela i usne šupljine indikuje ostale preglede, naročito endoskopske preglede sa biopsijom i histološkom verifikacijom sumnjive promene. Dijagnostika se dopunjuje shodno indikacijama ultrazvukom, radiografijom, kompjuterizovanom tomografijom, magnetnom rezonancom odgovarajućih regija, po potrebi i scintigrafijom skeleta, a poslednjih godina se primenjuje i pozitron emisiona tomografija, posebno u dijagnostici metastaza na vratu nepoznatog primarnog ishodišta. U lečenju, se primenjuju hiruške metode, radioterapija i hemioterapija, samostalno ili kombinovano, a nekada i molekularno bazirana terapija i imunoterapija.
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