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中枢神经系统肿瘤患者疾病及治疗相关并发症的管理

Managing Disease and Therapy-Related Complications in Patients with Central Nervous System Tumors.

作者信息

Raizer Jeffrey J, Dixit Karan S

机构信息

Department of Neurology, Division of Medical Neuro-Oncology, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Dr., Abbott Hall, Room 1123, Chicago, IL, 60611, USA,

出版信息

Curr Treat Options Oncol. 2015 Aug;16(8):38. doi: 10.1007/s11864-015-0357-1.

Abstract

Treating patients with brain tumors can be divided into tumor-directed therapies, the management of tumor-related symptoms and complications and the psychosocial aspect of patient care. In this review, we will discuss the management of disease and treatment-related complications, which can negatively impact patient quality of life and functional status. Brain edema is a common complication or brain tumors and often causes more symptoms than the tumor itself. Treatment options are limited to the use of corticosteroids, which although effective have a plethora of side effects, so the goal should be the lowest dose that maximizes symptoms. Seizures are more common in lower grade brain tumors and treatment should be limited to patients who have seizures using agents that do not affect the metabolism of other drugs, especially chemotherapies. Blood clots are also common in patients and although there is a "fear" of tumoral bleeding, this is not a frequent occurrence; hence, using anticoagulants should be routinely used in patients who experience this complication.

摘要

治疗脑肿瘤患者可分为针对肿瘤的治疗、肿瘤相关症状和并发症的管理以及患者护理的社会心理方面。在本综述中,我们将讨论疾病和治疗相关并发症的管理,这些并发症会对患者的生活质量和功能状态产生负面影响。脑水肿是脑肿瘤的常见并发症,通常比肿瘤本身引起更多症状。治疗选择仅限于使用皮质类固醇,虽然有效但有大量副作用,因此目标应该是使用能最大程度缓解症状的最低剂量。癫痫在低级别脑肿瘤中更常见,治疗应限于有癫痫发作的患者,使用不影响其他药物(尤其是化疗药物)代谢的药物。血栓在患者中也很常见,尽管存在“肿瘤出血”的“担忧”,但这种情况并不常见;因此,经历这种并发症的患者应常规使用抗凝剂。

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