Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC 27701, USA.
Cancer J. 2010 Sep-Oct;16(5):436-43. doi: 10.1097/PPO.0b13e3181f289f7.
This review aims to describe available standards for delivery of palliative and supportive care for cancer patients and discuss to what extent these guidelines have been evaluated and disseminated into standard care. Ovid searches were conducted to identify relevant guidelines, randomized studies comparing guideline-based care to usual care, and articles describing the use of guidelines in the usual care setting. Published guidelines address specific issues related to symptom management. Broader consensus statements have presented a framework for the delivery of palliative care for cancer patients. Dissemination of guidelines into standard care has been limited. Limited data suggest that implementation of palliative and supportive care guidelines can improve patient outcomes. Clinical trial publications rarely address supportive care in detail. Guideline efficacy has not been evaluated, and their dissemination into standard care has been poor. A conceptual framework for better implementation of existing guidelines might improve usage and outcomes.
这篇综述旨在描述现有的癌症患者姑息治疗和支持性护理标准，并讨论这些指南在多大程度上得到了评估和传播到常规护理中。我们通过 Ovid 检索来确定相关指南、比较基于指南的护理与常规护理的随机研究，以及描述在常规护理环境中使用指南的文章。已发布的指南解决了与症状管理相关的具体问题。更广泛的共识声明为癌症患者提供姑息治疗提供了框架。将指南传播到常规护理中受到限制。有限的数据表明，姑息治疗和支持性护理指南的实施可以改善患者的结局。临床试验出版物很少详细说明支持性护理。姑息治疗指南的疗效尚未得到评估，其在常规护理中的传播情况也不佳。一个更好地实施现有指南的概念框架可能会提高使用率和改善结局。
