Massachusetts General Hospital Cancer Center, Boston, MA, USA.
Chron Respir Dis. 2013 Feb;10(1):35-47. doi: 10.1177/1479972312471549.
Patients with advanced cancer experience a significant burden of physical symptoms and psychological distress at the end of life, and many elect to receive aggressive cancer-directed therapy. The goal of palliative care is to relieve suffering and promote quality of life (QOL) for patients and families. Traditionally, both the public and medical community have conceptualized the need for patients to make a choice between pursuing curative therapy or receiving palliative care. However, practice guidelines from the World Health Organization and leadership from the oncology and palliative care communities advocate a different model of palliative care that is introduced from the point of diagnosis of life-threatening illness. Early palliative care has been shown to provide benefits in QOL, mood, and health care utilization. Additionally, preliminary research has suggested that in contrast to fears about palliative care hastening death, referral to palliative care earlier in the course of illness may have the potential to lengthen survival, particularly in patients with advanced nonsmall-cell lung cancer. This review summarizes the literature on potential survival benefits of palliative care and presents a model of how early integrated palliative care could potentially influence survival in patients with advanced cancer.
晚期癌症患者在生命末期会经历身体症状和心理困扰的巨大负担，许多人选择接受积极的癌症治疗。姑息治疗的目标是减轻患者和家属的痛苦，提高生活质量（QOL）。传统上，公众和医学界都认为患者需要在追求治愈性治疗和接受姑息治疗之间做出选择。然而，世界卫生组织的实践指南和肿瘤学及姑息治疗领域的领导地位倡导了一种不同的姑息治疗模式，即从危及生命的疾病诊断时开始引入。早期姑息治疗已被证明能提高生活质量、改善情绪和减少医疗保健的利用。此外，初步研究表明，与对姑息治疗加速死亡的担忧相反，在疾病过程中更早地转介姑息治疗可能有延长生存的潜力，特别是在晚期非小细胞肺癌患者中。这篇综述总结了姑息治疗潜在生存获益的文献，并提出了一个模型，说明早期综合姑息治疗如何可能影响晚期癌症患者的生存。
