Zhang Liyan, Lu Yuhan
Department of GI Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China.
Department of Nursing, Peking University Cancer Hospital and Institute, Beijing, China.
Asia Pac J Oncol Nurs. 2021 Oct 4;8(6):596-603. doi: 10.4103/apjon.apjon-2129. eCollection 2021 Nov-Dec.
The rapid advances in cancer immunotherapy using immune checkpoint inhibitors (ICIs) have led to significantly improved survival of patients. But at the same time, it also associates with multiple immune-related adverse events (irAEs). The irAEs can affect a wide range of organs, and induce nonspecific symptoms with delayed onset and prolonged duration that is easily neglected, which may lead to life-threatening disorders. Therefore, follow-up care for patients receiving ICIs for irAEs management has become an essential competency in cancer nursing. There are several guidelines about the management of irAEs, which focused on diagnosis, grading, and treatment. However, studies on relevant follow-up care are rare. Nurses play an important role in follow-up care, whose relevant knowledge and skills are indispensable. Combined with domestic and foreign guidelines and related studies, this paper reviewed the occurrence and characteristics of irAEs and highlighted the contents, timing, models, and effects of follow-up care for patients receiving ICIs, to provide a reference for clinical nursing practice and improve the safety of immunotherapy for patients.
使用免疫检查点抑制剂(ICI)的癌症免疫疗法的迅速发展显著提高了患者的生存率。但与此同时,它也与多种免疫相关不良事件(irAE)相关。irAE可影响广泛的器官,并引发非特异性症状,其起病延迟且持续时间长,容易被忽视,这可能导致危及生命的疾病。因此,对接受ICI治疗的患者进行irAE管理的随访护理已成为癌症护理的一项基本能力。关于irAE管理有多项指南,其重点在于诊断、分级和治疗。然而,有关相关随访护理的研究很少。护士在随访护理中发挥着重要作用,其相关知识和技能不可或缺。结合国内外指南及相关研究,本文综述了irAE的发生情况和特点,并强调了接受ICI治疗患者的随访护理内容、时机、模式及效果,为临床护理实践提供参考,提高患者免疫治疗的安全性。