The Lilian and Benjamin Hertzberg Palliative Care Institute of the Brookdale Department of Geriatrics and Palliative Medicine, The Mount Sinai School of Medicine, New York, NY, United States.
Blood Rev. 2012 Nov;26(6):233-9. doi: 10.1016/j.blre.2012.07.001. Epub 2012 Aug 5.
Palliative medicine provides active evaluation and treatment of the physical, psychosocial and spiritual needs of patients and families with serious illnesses, regardless of curability or stage of illness. The hematologic malignancies comprise diverse clinical presentations, evolutions, treatment strategies and clinical and quality of life outcomes with dual potential for rapid clinical decline and ultimate improvement. While recent medical advances have led to cure, remission or long-term disease control for patients with hematologic malignancy, many still portend poor prognoses and all are associated with significant symptom and quality of life burden for patients and families. The gravity of a diagnosis of a hematologic malignancy also weighs heavily on the medical team, who typically develop close and long-term relationships with their patients. Palliative care teams provide an additional layer of support to patients, family caregivers, and the primary medical team through close attention to symptoms and emotional, practical, and spiritual needs. Barriers to routine palliative care co-management in hematologic malignancies include persistent health professional confusion about the role of palliative care and its distinction from hospice; inadequate availability of palliative care provider capacity; and widespread lack of physician training in communicating about achievable goals of care with patients, family caregivers, and colleagues. We herein review the evidence of need for palliative care services in hematologic malignancy patients in the context of a growing body of evidence demonstrating the beneficial outcomes of such care when provided simultaneously with curative or life-prolonging treatment.
姑息治疗为患有严重疾病的患者和家属提供积极的身体、心理社会和精神需求的评估和治疗，无论其可治愈性或疾病阶段如何。血液系统恶性肿瘤具有多样化的临床表现、演变、治疗策略以及临床和生活质量结局，具有快速临床恶化和最终改善的双重潜力。尽管最近的医学进展使血液系统恶性肿瘤患者的治愈、缓解或长期疾病控制成为可能，但许多患者仍预示着预后不良，所有患者都伴有显著的症状和生活质量负担，患者和家属也承受着巨大的压力。血液系统恶性肿瘤的诊断也给医疗团队带来了沉重的负担，他们通常与患者建立密切和长期的关系。姑息治疗团队通过密切关注症状以及情感、实际和精神需求，为患者、家庭照顾者和主要医疗团队提供额外的支持。在血液系统恶性肿瘤中，常规姑息治疗共同管理的障碍包括：医疗专业人员对姑息治疗的角色及其与临终关怀的区别持续存在混淆；姑息治疗提供者的能力不足；以及医生在与患者、家庭照顾者和同事沟通可实现的治疗目标方面的培训普遍缺乏。本文在越来越多的证据证明在提供姑息治疗与治愈或延长生命的治疗同时进行时，姑息治疗对血液系统恶性肿瘤患者具有有益的结局的背景下，综述了姑息治疗服务在血液系统恶性肿瘤患者中的需求证据。
