Kimura Takahiro
Department of Urology, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan.
Cancers (Basel). 2018 May 24;10(6):156. doi: 10.3390/cancers10060156.
Progress in cancer treatment has improved the survival of patients with advanced-stage cancers. Consequently, the clinical courses of patients are prolonged and often accompanied by morbidity due to bone metastases. Skeletal-related events (SREs), such as pathological fractures and spinal paralysis, cause impairment in activities of daily life and quality of life (QOL). To avoid serious SREs causing impairment in QOL and survival, early diagnosis and a prophylactic approach are required. It is necessary to initiate a bone management program concurrently with the initiation of cancer treatment to prevent complications of bone metastasis. In addition, the requirement of a multidisciplinary approach through a cancer board focusing on the management of bone metastases and involving a team of specialists in oncology, palliative care, radiotherapy, orthopedics, nuclear medicine, radiology, and physiatrists has been emphasized. In the cancer board, a strong focus is placed on the prevention of complications due to bone metastases and on reductions in the high morbidity, hospitalization rate, and overall costs associated with advanced-stage cancers. Recent reports suggest the usefulness of such approaches. The multidisciplinary approach through a cancer board would improve QOL and prognosis of patients, leading to new or continued systemic therapy for primary cancers.
癌症治疗的进展提高了晚期癌症患者的生存率。因此,患者的临床病程得以延长,且常伴有骨转移导致的发病情况。骨相关事件(SREs),如病理性骨折和脊髓麻痹,会导致日常生活活动能力和生活质量(QOL)受损。为避免严重的SREs损害生活质量和生存,需要进行早期诊断和采取预防措施。有必要在开始癌症治疗的同时启动骨管理计划,以预防骨转移的并发症。此外,强调了通过癌症委员会采取多学科方法的必要性,该委员会专注于骨转移的管理,涉及肿瘤学、姑息治疗、放射治疗、骨科、核医学、放射学和物理治疗师等专家团队。在癌症委员会中,重点是预防骨转移引起的并发症,并降低晚期癌症相关的高发病率、住院率和总体成本。最近的报告表明了这些方法的有效性。通过癌症委员会采取的多学科方法将改善患者的生活质量和预后,从而为原发性癌症带来新的或持续的全身治疗。