Neuro-Oncology Unit, Regina Elena Cancer Institute, Rome, Italy.
Department of Neurology, Leiden University Medical Center, Leiden, Netherlands; Department of Neurology, Haaglanden Medical Center, The Hague, Netherlands.
Lancet Oncol. 2017 Jun;18(6):e330-e340. doi: 10.1016/S1470-2045(17)30345-5.
Patients with glioma present with complex palliative care needs throughout their disease trajectory. The life-limiting nature of gliomas and the presence of specific symptoms related to neurological deterioration necessitate an appropriate and early palliative care approach. The multidisciplinary palliative care task force of the European Association of Neuro-Oncology did a systematic review of the available scientific literature to formulate the best possible evidence-based recommendations for the palliative care of adult patients with glioma, with the aim to reduce symptom burden and improve the quality of life of patients and their caregivers, particularly in the end-of-life phase. When recommendations could not be made because of the scarcity of evidence, the task force either used evidence from studies of patients with systemic cancer or formulated expert opinion. Areas of palliative care that currently lack evidence and thus deserve attention for further research are fatigue, disorders of behaviour and mood, interventions for the needs of caregivers, and timing of advance care planning.
脑胶质瘤患者在疾病过程中表现出复杂的姑息治疗需求。脑胶质瘤的生命有限性和与神经恶化相关的特定症状需要适当和早期的姑息治疗方法。欧洲神经肿瘤学会的多学科姑息治疗工作组对现有科学文献进行了系统回顾,为成人脑胶质瘤患者的姑息治疗制定了尽可能最佳的循证建议,旨在减轻症状负担,改善患者及其护理人员的生活质量,特别是在临终阶段。由于证据稀缺而无法提出建议的情况下,工作组要么使用来自系统性癌症患者研究的证据,要么制定专家意见。姑息治疗领域目前缺乏证据,因此值得进一步研究关注的领域包括疲劳、行为和情绪障碍、护理人员需求的干预措施以及预先护理计划的时间。