Departments of Pediatrics and Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
Hematol Oncol Clin North Am. 2010 Feb;24(1):129-49. doi: 10.1016/j.hoc.2009.11.013.
Childhood cancer survivors are at increased risk of serious morbidity, premature mortality, and diminished health status. Proactive and anticipatory risk-based health care of survivors and healthy lifestyles can reduce these risks. In this article, the authors first briefly discuss four common problems of survivors: neurocognitive dysfunction, cardiovascular disease, infertility and gonadal dysfunction, and psychosocial problems. Second, the authors discuss the concept of risk-based care, promote the use of recently developed evidence-based guidelines, describe current care in the United States, Canada, and the Netherlands, and articulate a model for shared survivor care that aims to optimize life long health of survivors and improve two-way communication between the cancer center and the primary care physician.
儿童癌症幸存者面临着严重发病、过早死亡和健康状况下降的风险增加。对幸存者进行积极的、前瞻性的基于风险的保健和健康的生活方式可以降低这些风险。在本文中，作者首先简要讨论了幸存者的四个常见问题：神经认知功能障碍、心血管疾病、不孕和性腺功能障碍以及心理社会问题。其次，作者讨论了基于风险的护理的概念，促进了最近制定的基于证据的指南的使用，描述了美国、加拿大和荷兰的当前护理情况，并阐述了一个旨在优化幸存者的长期健康并改善癌症中心和初级保健医生之间双向沟通的共享幸存者护理模型。
