Center for Pediatric Nursing Research & Evidence-Based Practice, Nursing & Clinical Care Services, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Division of Pediatric Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Support Care Cancer. 2023 Oct 7;31(10):617. doi: 10.1007/s00520-023-08101-x.
Dose-limiting toxicities are ubiquitous to cancer-directed therapy, presenting with severity to a degree that necessitates therapy de-escalation, pause, or discontinuation. To date, there is incredible limited understanding if these therapy de-escalations present risk for survival by limiting delivery of intensive therapy, or if they indicate physiologic susceptibility and are a favorable prognostic indicator. Mucositis is an excellent illustration of the current paradox of dose-limiting toxicities-it has existed alongside therapy for eight decades, but despite its presence, there is an incomplete understanding of how it develops, why it varies between oncologic populations, and if it relates to cancer survival. Rigorous methodologic approaches in symptom science holds potential to better understand mucositis, to determine if it is a marker of response or threat, and evaluate if it holds potential to guide therapy delivery.
剂量限制毒性在癌症治疗中普遍存在，其严重程度需要降低治疗强度、暂停或停止治疗。迄今为止，人们对这些治疗强度的降低是否会因限制强化治疗的实施而对生存构成风险，或者它们是否表明生理易感性并作为有利的预后指标，知之甚少。黏膜炎是目前剂量限制毒性悖论的一个很好的例子——它已经存在于癌症治疗的八十年中，但尽管它存在，人们对其发展机制、为何在不同肿瘤人群中存在差异以及是否与癌症生存相关等方面的认识仍不完整。在症状科学中采用严格的方法学方法有可能更好地了解黏膜炎，确定其是否是反应或威胁的标志物，并评估其是否有可能指导治疗。
