Hoskin P J, Hanks G W
Continuing Care Unit, Royal Marsden Hospital, Sutton, Surrey.
J R Soc Med. 1988 Jun;81(6):341-4. doi: 10.1177/014107688808100615.
The treatment received by 158 patients with advanced cancer admitted over one year to the Continuing Care Unit at the Royal Marsden Hospital has been reviewed. The unit is an integral part of the hospital and this is reflected in the fact that 46 patients (29%) received radiotherapy, hormone therapy, chemotherapy or surgery in addition to symptomatic treatment for palliation of troublesome symptoms. One hundred and thirty-one patients received oral morphine in doses ranging from 2.5 mg 4-hourly to 700 mg 4-hourly. Patients with renal or hepatic impairment required lower doses of morphine and there was a highly significant inverse relationship between morphine dose and age. Eighty-five patients (54%) received parenteral diamorphine at some time due to their inability to take oral morphine. One hundred and twenty-three patients (78%) received a co-analgesic drug and anti-emetics were required by 78 patients (49% overall; 56% of those receiving morphine). Transcutaneous electrical nerve stimulation, acupuncture and relaxation were employed in selected patients, and graduated compression sleeves were used to treat lymphoedema. These data highlight the wide range of therapeutic options available to control the symptoms of advanced cancer and also indicate that tumoricidal treatments used in conjunction with symptomatic treatments may have a significant part to play.
对皇家马斯登医院持续护理病房一年内收治的158例晚期癌症患者的治疗情况进行了回顾。该病房是医院的一个组成部分，这体现在46例患者（29%）除了接受缓解棘手症状的对症治疗外，还接受了放疗、激素治疗、化疗或手术。131例患者接受口服吗啡，剂量从每4小时2.5毫克到每4小时700毫克不等。肾功能或肝功能受损的患者需要较低剂量的吗啡，且吗啡剂量与年龄之间存在高度显著的负相关关系。85例患者（54%）因无法口服吗啡而在某些时候接受了胃肠外二醋吗啡。123例患者（78%）接受了辅助镇痛药，78例患者（总体49%；接受吗啡患者中的56%）需要使用止吐药。部分患者采用了经皮电刺激神经疗法、针灸和放松疗法，还使用了渐进性加压袖套来治疗淋巴水肿。这些数据凸显了控制晚期癌症症状可用的广泛治疗选择，也表明与对症治疗联合使用的杀肿瘤治疗可能发挥重要作用。
