Ladas Elena J, Marjerrison Stacey, Arora Brijesh, Hesseling Peter B, Ortiz Roberta, Antillon Federico, Jatia Shalini, Afungchwi Glenn M
Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY; Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada; Department of Pediatric Oncology, Tata Memorial Hospital, Mumbai, India; Department of Pediatrics and Child Health, Tygerberg Childrens' Hospital, University of Stellenbosch, Stellenbosch, South Africa; Pediatric Hematology-Oncology Department, Manuel de Jesus Rivera La Mascota, Children's Hospital, Managua, Nicaragua; Hemato-Oncology Service, Unidad Nacional de Oncologia Pediatrica, Guatemala City, Guatemala; Medical School Francisco Marroquín University, Guatemala City, Guatemala; Banso Baptist Hospital, Kumbo, Cameroon.
J Natl Cancer Inst Monogr. 2017 Nov 1;2017(52). doi: 10.1093/jncimonographs/lgx014.
Significant strides have been made in the treatment of childhood cancer. Improvements in survival have led to increased attention toward supportive care indications; including the use of traditional and complementary medicine (T&CM). The use of T&CM among children and adolescents with cancer is well documented in both high-income countries (HICs) and low-middle income countries (LMICs). A higher incidence of the use of T&CM has been reported among children undergoing treatment in LMICs, which has elevated concerns related to drug interactions, adherence to therapy, and treatment-related toxicities. These observations have underscored the need for effective models of integrative care that are culturally sensitive yet sustainable in an LMIC setting. We present considerations inclusive of the clinical care, educational opportunities, governmental policy, and research priorities necessary for the development of models of integrative care for pediatric cancer units in an LMIC setting.
儿童癌症治疗已取得显著进展。生存率的提高使得对支持性护理指征的关注增加，包括传统医学和补充医学（T&CM）的使用。在高收入国家（HICs）和低收入中等收入国家（LMICs），癌症儿童和青少年使用T&CM的情况都有充分记录。据报道，在LMICs接受治疗的儿童中，T&CM的使用率更高，这引发了对药物相互作用、治疗依从性和治疗相关毒性的更多关注。这些观察结果凸显了在LMIC环境中建立具有文化敏感性且可持续的综合护理有效模式的必要性。我们提出了在LMIC环境中为儿科癌症病房开发综合护理模式所需考虑的因素，包括临床护理、教育机会、政府政策和研究重点。
