Palliative Care in High-Grade Glioma: A Review.
Palliative Care in High-Grade Glioma: A Review.
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DOI：
10.3390/brainsci10100723
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发表时间：
2020-10-13
期刊：
影响因子：
3.3
通讯作者：
Vickrey BG
中科院分区：
文献类型：
--
作者：
Crooms RC;Goldstein NE;Diamond EL;Vickrey BG
高级别胶质瘤（HGG）的特点是衰弱的神经症状和预后差。这种疾病产生的一些痛苦可以通过姑息治疗来改善，姑息治疗通过优化症状管理和心理社会支持来改善重病患者的生活质量，这些支持可以与癌症治疗同时提供。在这篇文章中，我们回顾了与HGG相关的姑息治疗需求，并确定了初级和专业姑息治疗干预的机会。HGG患者及其护理人员由于身体，情绪和认知症状而经历高水平的痛苦，这些症状对生活质量和功能独立性产生负面影响，所有这些都是在预期寿命有限的情况下。然而，患者通常在生命结束前与专业姑息治疗的接触有限，并且没有建立模型来确保他们的姑息治疗需求在整个疾病过程中得到满足。我们确定了提前护理计划的低比率，对姑息治疗的误解是临终关怀的同义词，以及这一患者群体独特的神经系统需求，这些都是增加姑息干预的潜在障碍。需要进一步的研究来确定神经肿瘤学家和姑息治疗专家在这种疾病的管理中的最佳作用，并建立适当的姑息治疗提供的时间和模式。
High-grade glioma (HGG) is characterized by debilitating neurologic symptoms and poor prognosis. Some of the suffering this disease engenders may be ameliorated through palliative care, which improves quality of life for seriously ill patients by optimizing symptom management and psychosocial support, which can be delivered concurrently with cancer-directed treatments. In this article, we review palliative care needs associated with HGG and identify opportunities for primary and specialty palliative care interventions. Patients with HGG and their caregivers experience high levels of distress due to physical, emotional, and cognitive symptoms that negatively impact quality of life and functional independence, all in the context of limited life expectancy. However, patients typically have limited contact with specialty palliative care until the end of life, and there is no established model for ensuring their palliative care needs are met throughout the disease course. We identify low rates of advance care planning, misconceptions about palliative care being synonymous with end-of-life care, and the unique neurologic needs of this patient population as some of the potential barriers to increased palliative interventions. Further research is needed to define the optimal roles of neuro-oncologists and palliative care specialists in the management of this illness and to establish appropriate timing and models for palliative care delivery.
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