Husson O, Manten-Horst E, van der Graaf W T A
Prog Tumor Res. 2016;43:50-63. doi: 10.1159/000447071. Epub 2016 Sep 5.
Awareness of the need for collaboration across pediatric and adult cancer to care for adolescents and young adults (AYAs) arose from the recognition of the unique characteristics of AYAs with cancer. Neither pediatric nor adult oncology hospital departments are able to provide age-appropriate care single handedly. The best way to bridge the gap in care of AYA cancer patients is to centralize aspects of their care within dedicated AYA care programs, including the following essential components: provision of developmentally appropriate and multidisciplinary (supportive) care, availability of AYA inpatient and outpatient facilities and healthcare professional AYA expertise as collaboration between adult and pediatric departments. Barriers are related to the slowly emerging evidence of benefit, cultural differences (collaboration between pediatric and adult oncology professionals), administrative and logistic challenges (small number of AYAs makes it difficult to create an AYA program in every hospital) and financial aspects (dependency on philanthropic funds). The sustainable development of an AYA program requires acceptance as a standard of care at the clinical and patient community and at government level. To improve the quality, equity and quantity of research and innovation in AYA cancer care across the world, it is necessary to join forces and collaborate in international networks to study issues such as the features of quality care, collaboration between pediatric and adult clinical teams, trial groups and professional societies, and AYA-specific groups such as Critical Mass, Canteen or European Network for Teenagers and Young Adults with Cancer.
认识到需要跨儿科和成人癌症领域进行合作以照顾青少年和青年成人(AYA),这源于对患癌AYA独特特征的认识。儿科和成人肿瘤医院科室都无法单独提供适合其年龄阶段的护理。弥合AYA癌症患者护理差距的最佳方法是在专门的AYA护理项目中集中其护理的各个方面,包括以下基本组成部分:提供适合其发育阶段的多学科(支持性)护理、提供AYA住院和门诊设施以及具备成人和儿科科室合作的医疗保健专业人员的AYA专业知识。障碍涉及效益证据的缓慢显现、文化差异(儿科和成人肿瘤专业人员之间的合作)、行政和后勤挑战(AYA数量少使得在每家医院创建AYA项目困难)以及财务方面(依赖慈善基金)。AYA项目的可持续发展需要在临床、患者群体以及政府层面被接受为一种护理标准。为了提高全球AYA癌症护理研究与创新的质量、公平性和数量,有必要联合起来并在国际网络中开展合作,以研究诸如优质护理的特点、儿科和成人临床团队之间的合作、试验组和专业协会以及AYA特定群体(如Critical Mass、Canteen或欧洲青少年和青年成人癌症网络)等问题。