Department of Medical Oncology, Cancer and Blood Diseases, Grenoble Alpes University Hospital, Grenoble, France.
Department of AYA Unit and Public Health, Grenoble Alpes University Hospital, Grenoble, France.
J Adolesc Young Adult Oncol. 2023 Aug;12(4):546-554. doi: 10.1089/jayao.2022.0061. Epub 2022 Nov 21.
This study was undertaken to describe the Adolescents and Young Adults' (AYA-aged patients') neuro-oncology care pathways at Grenoble Alpes University Hospital according to the French health recommendations. A retrospective monocentric observational study was conducted between 2020 and 2021, on patients 13-29 years of age, diagnosed from January 2013 to 2019 in our institute with a primary brain tumor, excluding meningiomas, schwannomas, and neurinomas. The detailed analysis took into account the type of care unit (adult or pediatric), whether or not a dedicated AYA support team was involved, and various pretherapeutic actions. Sixty patients were included in this study. Three of the 9 key stages of the care process were completed regardless of the type of management. Management in a pediatric oncology department seems to improve multidisciplinary discussions and access to the AYA team. Collaboration with an AYA team seems to improve the recourse to pediatric advice and supportive care. Increased vigilance at all key steps as defined in the recommendations of the Directorate General of Healthcare Services would significantly improve the overall quality of care for this specific population. In the absence of a dedicated AYA hospitalization unit, interdisciplinary cooperation between the different professionals of the adult and pediatric services is essential, and the involvement of the AYA mobile team is a factor that favors links and exchanges and ultimately an overall improvement in patient care and life. We propose our vision of an ideal AYA neuro-oncology care pathway.
本研究旨在根据法国卫生建议,描述格勒诺布尔阿尔卑斯大学医院青少年和年轻成人(AYA 年龄段患者)神经肿瘤学的护理路径。这是一项回顾性单中心观察性研究,于 2020 年至 2021 年期间在我们机构中进行,纳入了年龄在 13-29 岁之间、2013 年 1 月至 2019 年期间在我院诊断为原发性脑肿瘤(脑膜瘤、神经鞘瘤和神经纤维瘤除外)的患者。详细分析考虑了护理单元的类型(成人或儿科)、是否涉及专门的 AYA 支持团队,以及各种治疗前的行动。这项研究共纳入了 60 名患者。无论管理类型如何,有 9 个关键护理阶段中的 3 个阶段已经完成。在儿科肿瘤病房进行管理似乎可以改善多学科讨论和 AYA 团队的介入。与 AYA 团队的合作似乎可以提高对儿科咨询和支持性护理的利用。在所有建议中定义的关键步骤中增加警惕性,将显著提高对这一特定人群的整体护理质量。在没有专门的 AYA 住院病房的情况下,成人和儿科服务的不同专业人员之间的跨学科合作至关重要,AYA 移动团队的介入是有利于联系和交流的因素,最终可以整体改善患者的护理和生活。我们提出了我们对理想的 AYA 神经肿瘤学护理路径的设想。