Aboulafia Albert J, Levine Alan M, Schmidt Daniel, Aboulafia David
Sarcoma Services, The Cancer Institute at Sinai Hospital, University of Maryland, Department of Orthopaedic Surgery, Baltimore, MD 21215, USA.
Semin Oncol. 2007 Jun;34(3):206-14. doi: 10.1053/j.seminoncol.2007.03.002.
The treatment of patients with cancer epitomizes the importance of using a collaborative team approach to optimize patient care. Physician team members most commonly are radiation oncologists, general surgeons, surgical oncologists, thoracic surgeons, neurosurgeons, and orthopedic surgeons. When patients are receiving chemotherapy, their medical oncologist frequently takes responsibility for coordinating care among the various team members and initiating consultations with necessary providers. When patients develop bone metastases or chemotherapy-induced bone loss (CTIBL), the orthopedic surgeon may be able to improve the patient's quality of life greatly. Procedures orthopedists perform most commonly include open reduction and internal fixations and arthroplasties (joint replacement surgery). Less invasive procedures currently being tested include stereotactic radiosurgery, radiofrequency ablation (RFA), and percutaneous cementoplasty. By understanding the options available to patients with skeletal complications of malignancy, the medical oncologist can discuss issues with patients and make appropriate referrals for diagnosis and treatment. Additionally, with a greater understanding of the surgical procedures available, the medical oncologist will be better able to assist in preparing the patient for surgery.
癌症患者的治疗集中体现了采用协作团队方法以优化患者护理的重要性。医师团队成员通常包括放射肿瘤学家、普通外科医生、外科肿瘤学家、胸外科医生、神经外科医生和骨科医生。当患者接受化疗时，他们的肿瘤内科医生通常负责协调各团队成员之间的护理工作，并与必要的医疗服务提供者进行会诊。当患者发生骨转移或化疗引起的骨质流失（CTIBL）时，骨科医生可能能够极大地改善患者的生活质量。骨科医生最常进行的手术包括切开复位内固定术和关节成形术（关节置换手术）。目前正在测试的侵入性较小的手术包括立体定向放射外科手术、射频消融（RFA）和经皮骨水泥成形术。通过了解恶性肿瘤骨骼并发症患者可选择的治疗方案，肿瘤内科医生可以与患者讨论相关问题，并做出适当的诊断和治疗转诊。此外，对现有手术程序有更深入的了解后，肿瘤内科医生将更有能力协助患者做好手术准备。
