[Overtreatment in advanced tumors of the head and neck]. / L'accanimento terapeutico nei tumori avanzati della testa e del collo.

So-called "over-treatment" in the practical management of advanced head and neck tumors is a very important problem in terms of its professional, ethical, moral and legal implications, that involve the physician in the therapeutic decision he must make. After presenting the general aspects of the subject, the chairman, together with all those participating in the Round Table, deals with the most important points of the problem: the definition of overtreatment, the limits of treatment, nontreatment, passive euthanasia, informed consent and quality of life. The various aspects of the problem have been dealt with and discussed from the point of view of the surgeon, the expert in bio-ethics and the magistrate. After comparing the different opinions, the most important point, in terms of a therapeutic choice, should be the patient's quality of life, whose improvement justifies every therapeutic strategy. Given that the advances in surgery, either demolitive or above all reconstructive, have made almost every operation technically possible, attention has been concentrated on overtreatment in nonsurgical therapies. In extremely advanced tumors, radio- and chemotherapy are often burdened by side effects and sequelae that lead to a quality of life at the limits of biological supportability. The Round Table ends with the presentation of emblematic case reports, followed by a vivacious discussion, also with those in the audience, that was basically in agreement with the therapeutic choices made.