Archer V R, Billingham L J, Cullen M H
Queen Elizabeth Hospital, Birmingham, UK.
Oncologist. 1999;4(6):470-7.
Palliative chemotherapy is defined as treatment in circumstances where the impact of intervention is insufficient to result in major survival advantage, but does affect improvement in terms of tumor-related symptoms, and where the palliation/toxicity trade-off from treatment clearly favors symptom relief. The role of chemotherapy in circumstances where little or no survival benefit is anticipated remains controversial. This is despite the mounting body of evidence in favor of its use for symptom palliation. The notion persists that outcomes other than significant survival benefit are not valid, because of firmly held perceptions of toxicity. Studies of chemotherapeutic palliation using valid measures of quality of life, show that patients may be willing to accept some side effects of treatment, as long as they gain relief from tumor-related symptoms. The aims of this review are to present the case for palliative chemotherapy, to highlight the areas of progress which have made this feasible, and to provide guidance with regard to its appropriate use.
干预的影响不足以带来显著的生存优势，但确实能改善肿瘤相关症状，且治疗的姑息效果/毒性权衡明显有利于症状缓解。在预期几乎没有或没有生存益处的情况下，化疗的作用仍存在争议。尽管有越来越多的证据支持将其用于症状缓解，但这种争议仍然存在。由于对毒性的固有认知，人们仍然认为除了显著的生存益处之外的结果是无效的。使用有效的生活质量衡量标准对化疗姑息治疗进行的研究表明，只要患者能从肿瘤相关症状中得到缓解，他们可能愿意接受治疗的一些副作用。本综述的目的是阐述姑息性化疗的理由，突出使其可行的进展领域，并就其合理使用提供指导。
