Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update
Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update
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DOI：
10.1200/jco.2016.70.1474
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发表时间：
2017-01-01
影响因子：
45.3
通讯作者：
Smith, Thomas J.
中科院分区：
文献类型：
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作者：
Ferrell, Betty R.;Temel, Jennifer S.;Smith, Thomas J.
目的为肿瘤临床医生、患者、家属和朋友照顾者以及姑息治疗专家提供循证建议，以更新2012年美国临床肿瘤学会（ASCO）关于将姑息治疗纳入所有确诊癌症患者的标准肿瘤治疗的临时临床意见（PCO）。方法sasco召集了由ASCO特设姑息治疗专家小组成员组成的专家小组来制定最新情况。2012年的PCO是基于对国家癌症研究所医师数据查询和其他试验的随机对照试验（RCT）的回顾。该小组对2010年3月至2016年1月发表的2012年PCO中的随机临床试验、系统评价、荟萃分析以及随机对照试验进行了更新的系统评价。结果指南的更新反映了自前一指南以来证据的变化。9项随机对照试验、1项准实验试验和5项来自2012年PCO中关于为癌症患者和/或其照顾者（包括家庭照顾者）提供姑息治疗服务的随机对照试验的二次分析为更新提供了信息。建议晚期癌症患者和门诊患者应在病程早期接受专门的姑息治疗服务，同时积极治疗。转介患者到跨学科姑息治疗团队是最佳的，服务可以补充现有的方案。提供者可能会将早期或晚期癌症患者的家人和朋友照顾者推荐给姑息治疗服务。(C) 2016年由美国临床肿瘤学会出版
PurposeTo provide evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists to update the 2012 American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) on the integration of palliative care into standard oncology care for all patients diagnosed with cancer.MethodsASCO convened an Expert Panel of members of the ASCO Ad Hoc Palliative Care Expert Panel to develop an update. The 2012 PCO was based on a review of a randomized controlled trial (RCT) by the National Cancer Institute Physicians Data Query and additional trials. The panel conducted an updated systematic review seeking randomized clinical trials, systematic reviews, and meta-analyses, as well as secondary analyses of RCTs in the 2012 PCO, published from March 2010 to January 2016.ResultsThe guideline update reflects changes in evidence since the previous guideline. Nine RCTs, one quasiexperimental trial, and five secondary analyses from RCTs in the 2012 PCO on providing palliative care services to patients with cancer and/or their caregivers, including family caregivers, were found to inform the update.RecommendationsInpatients and outpatients with advanced cancer should receive dedicated palliative care services, early in the disease course, concurrent with active treatment. Referral of patients to interdisciplinary palliative care teams is optimal, and services may complement existing programs. Providers may refer family and friend caregivers of patients with early or advanced cancer to palliative care services. (C) 2016 by American Society of Clinical Oncology