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姑息治疗在改善患者预后方面的效果如何?

How Effective Is Palliative Care in Improving Patient Outcomes?

机构信息

Department of Pediatrics State University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA.

Department of Supportive and Palliative Care, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.

出版信息

Curr Treat Options Oncol. 2020 Feb 5;21(2):12. doi: 10.1007/s11864-020-0702-x.

Abstract

As palliative care (PC) continues its rapid growth, an emerging body of evidence is demonstrating that its approach of interdisciplinary supportive care benefits many patient populations, including in the oncology setting. As studies and data proliferate, however, questions persist about who, what, why, when, and how PC as well as the ideal time for a PC consult and length of involvement. When comparing outcomes from chemotherapy trials, it is important to consider the dosing regimens used in the various studies. In the same way, it is important to account for the "dose" of the PC interventions utilized across studies, and apples to apples comparisons are needed in order to draw accurate conclusions about PC's benefits. Studies which include a true interdisciplinary PC intervention consistently show improvements in patient quality of life, as well as cost savings, with further study needed for other outcomes. These benefits cannot be extrapolated to care which may be labeled "palliative care," but which does not meet the standard of true interdisciplinary PC. The ultimate question is: Does PC indeed improve outcomes?

摘要

随着姑息治疗(PC)的快速发展,越来越多的证据表明,其跨学科支持性治疗方法使许多患者群体受益,包括肿瘤患者。然而,随着研究和数据的不断增加,人们对 PC 的对象、内容、原因、时间和方式以及 PC 咨询的理想时间和参与时间仍存在疑问。在比较化疗试验的结果时,重要的是要考虑到不同研究中使用的剂量方案。同样,重要的是要考虑到跨研究中使用的 PC 干预措施的“剂量”,并且需要进行苹果对苹果的比较,以便就 PC 的益处得出准确的结论。包含真正跨学科 PC 干预的研究始终表明,患者的生活质量得到改善,同时也节省了成本,其他结果还需要进一步研究。这些益处不能推断为可能被贴上“姑息治疗”标签但不符合真正跨学科 PC 标准的护理。最终的问题是:姑息治疗是否确实能改善预后?

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