Tassinari Davide, Maltoni Marco
Modulo di Terapie di Supporto e Palliative, Divisione di Oncologia, Ospedale Civile degli Infermi, Rimini.
Recenti Prog Med. 2006 Oct;97(10):571-9.
The rediscovery of palliative care in oncology represents an important aspect in the clinical assistance of cancer patients with advanced or terminal disease. The main characteristic aspects of the renewed medical discipline are: the inclusion of palliative care within the comprehensive care of the oncologic patient (simultaneous care); the inclusion of the palliative care institutions (Hospices and Home Care Units) within the oncologic departments; the comprehensive approach towards the sick person and his family in a model of global care; the identification of quality of life as the main end point of a palliative approach. An adequate approach to the needs of the patient with advanced or terminal disease or to the needs of his family has to be based upon a correct assessment of the patient, and consequently of patient's prognosis. Moreover, clinical research should be based on rational principles and conducted with adequate and well-founded methodologies. Future aims for palliative care will be: the identification of foundation confirmed by basic or translational research, the conduction of trials that could validate the results of biological research in the clinical context, and the large application of the results of clinical research in clinical practice. Nevertheless, all the efforts to improve the quality of clinical research in palliative care will have to be focused on protocols of global interventions.
肿瘤学中姑息治疗的重新发现是晚期或终末期癌症患者临床护理的一个重要方面。这一新兴医学学科的主要特征包括:将姑息治疗纳入肿瘤患者的综合护理(同步护理);将姑息治疗机构(临终关怀医院和家庭护理单位)纳入肿瘤科室;在整体护理模式中对患者及其家属采取综合方法;将生活质量确定为姑息治疗的主要终点。对晚期或终末期疾病患者及其家属需求的适当处理方法必须基于对患者的正确评估,进而基于对患者预后的评估。此外,临床研究应基于合理原则,并采用充分且有充分依据的方法进行。姑息治疗未来的目标将是:确定基础研究或转化研究证实的基础,开展能够在临床环境中验证生物学研究结果的试验,以及将临床研究结果广泛应用于临床实践。然而,提高姑息治疗临床研究质量的所有努力都必须集中在整体干预方案上。