Department of Physical Medicine and Rehabilitation, MetroHealth Rehabilitation Institute of Ohio, Case Western Reserve University, Cleveland, OH 44109, USA.
Am J Phys Med Rehabil. 2011 May;90(5 Suppl 1):S50-62. doi: 10.1097/PHM.0b013e31820be31f.
Brain and other central nervous system tumors have a very high likelihood of producing long-term disabling effects owing to the tumor itself and the effects of treatment, including surgical complications, neurotoxic effects of radiation, and debility caused by chemotherapy. Even benign or low-grade brain tumors can cause significant disability. Brain tumors occur over the life span, showing progressively higher incidence with advancing age. The common types of primary brain tumor differ between pediatric and adult age groups. Evidence for effectiveness of rehabilitation is favorable. Brain tumor patients treated in acute rehabilitation settings improve comparably with individuals with stroke or traumatic brain injury. Although patients with primary brain tumors have been better studied than those with metastatic disease, significant gains with inpatient rehabilitation have been reported in the latter group also. Outpatient programs to address cognitive deficits in brain tumor survivors, including cognitive therapy and pharmacologic strategies, have found benefit. While the patient is receiving rehabilitation care, physiatrists, in interdisciplinary collaboration with the pertinent oncology-related services, assist with managing symptoms including fatigue, headache, and sleep disturbance and medical complications including depression, seizures, and thromboembolic disease. Better methods are needed to identify patients for rehabilitation services when appropriate over the course of the disease process.
脑和其他中枢神经系统肿瘤由于肿瘤本身以及治疗的影响，包括手术并发症、放射的神经毒性作用和化疗引起的虚弱，极有可能产生长期致残影响。即使是良性或低级别脑肿瘤也会导致严重残疾。脑肿瘤发生于整个生命过程中，随着年龄的增长，发病率逐渐升高。儿童和成人年龄组的原发性脑肿瘤常见类型不同。康复效果的证据是有利的。在急性康复环境中治疗的脑肿瘤患者与中风或创伤性脑损伤患者的改善情况相当。尽管原发性脑肿瘤患者比转移性疾病患者的研究更为充分，但在后者中也报告了住院康复的显著获益。针对脑肿瘤幸存者认知缺陷的门诊项目，包括认知疗法和药物策略，已经发现了益处。在患者接受康复治疗期间，物理治疗师与相关肿瘤学相关服务进行跨学科合作，协助管理症状，包括疲劳、头痛和睡眠障碍，以及医疗并发症，包括抑郁、癫痫和血栓栓塞性疾病。需要更好的方法来确定在疾病过程中适当的时候为康复服务选择患者。
