Krishnan Monica, Temel Jennifer S, Wright Alexi A, Bernacki Rachelle, Selvaggi Kathy, Balboni Tracy
Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA.
J Support Oncol. 2013 Jun;11(2):68-74. doi: 10.12788/j.suponc.0004.
Oncologists frequently face the difficult task of estimating prognosis in patients with incurable malignancies. Their prediction of prognosis informs decision-making ranging from recommendations of cancer treatments to hospice enrollment. Unfortunately, physicians' estimates of prognosis are often inaccurate and overly optimistic. Further, physicians often fail to disclose their prognosis estimates, despite patient wishes to the contrary. Several studies have examined patient factors that might improve physicians' prognostic accuracy, including performance status, clinical symptoms and laboratory values. Prognostic models have been developed and validated but, to date, none are able to provide accurate estimates throughout the spectrum of advanced illness. This review examines tools utilized to predict life expectancy for patients with advanced, incurable cancer.
肿瘤学家常常面临着为无法治愈的恶性肿瘤患者评估预后这一艰巨任务。他们对预后的预测为从癌症治疗建议到临终关怀登记等一系列决策提供依据。不幸的是，医生对预后的评估往往不准确且过于乐观。此外，尽管患者有相反的意愿，医生常常未能透露他们对预后的评估。多项研究探讨了可能提高医生预后预测准确性的患者因素，包括体能状态、临床症状和实验室检查值。预后模型已经开发并得到验证，但迄今为止，尚无一种模型能够在整个晚期疾病范围内提供准确的评估。本综述探讨了用于预测晚期无法治愈癌症患者预期寿命的工具。
