Early palliative care and metastatic non-small cell lung cancer: Potential mechanisms of prolonged survival
Early palliative care and metastatic non-small cell lung cancer: Potential mechanisms of prolonged survival
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DOI：
10.1177/1479972312471549
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发表时间：
2013-02-01
影响因子：
4.1
通讯作者：
Pirl, William F.
中科院分区：
文献类型：
--
作者：
Irwin, Kelly E.;Greer, Joseph A.;Pirl, William F.
晚期癌症患者在临终时承受着巨大的身体症状和心理困扰，许多人选择接受积极的癌症定向治疗。姑息治疗的目标是减轻患者及其家人的痛苦并提高生活质量 (QOL)。传统上，公众和医学界都认为患者需要在接受治疗或接受姑息治疗之间做出选择。然而，世界卫生组织的实践指南以及肿瘤学和姑息治疗界的领导层提倡从危及生命的疾病的诊断角度引入不同的姑息治疗模式。早期姑息治疗已被证明可以在生活质量、情绪和医疗保健利用方面带来好处。此外，初步研究表明，与对姑息治疗加速死亡的担忧相反，在病程早期转诊姑息治疗可能有可能延长生存期，特别是对于晚期非小细胞肺癌患者。本综述总结了有关姑息治疗潜在生存益处的文献，并提出了早期综合姑息治疗如何可能影响晚期癌症患者生存的模型。
Patients with advanced cancer experience a significant burden of physical symptoms and psychological distress at the end of life, and many elect to receive aggressive cancer-directed therapy. The goal of palliative care is to relieve suffering and promote quality of life (QOL) for patients and families. Traditionally, both the public and medical community have conceptualized the need for patients to make a choice between pursuing curative therapy or receiving palliative care. However, practice guidelines from the World Health Organization and leadership from the oncology and palliative care communities advocate a different model of palliative care that is introduced from the point of diagnosis of life-threatening illness. Early palliative care has been shown to provide benefits in QOL, mood, and health care utilization. Additionally, preliminary research has suggested that in contrast to fears about palliative care hastening death, referral to palliative care earlier in the course of illness may have the potential to lengthen survival, particularly in patients with advanced nonsmall-cell lung cancer. This review summarizes the literature on potential survival benefits of palliative care and presents a model of how early integrated palliative care could potentially influence survival in patients with advanced cancer.