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缓和医疗肿瘤委员会:一项叙事性综述,并介绍一种新型会议,以加强对晚期癌症患者疼痛和症状管理的协作与协调。

Palliative care tumor board: a narrative review and presentation of a novel conference to enhance collaboration and coordination of pain and symptom management for patients with advanced cancer.

机构信息

Lifespan Cancer Institute, Rhode Island Hospital, Providence, RI, USA; Alpert Medical School of Brown University, Providence, RI, USA; Department of Geriatrics and Palliative Care, Alpert Medical School of Brown University, Providence, RI, USA.

Lifespan Cancer Institute, Rhode Island Hospital, Providence, RI, USA; Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.

出版信息

Ann Palliat Med. 2024 May;13(3):558-567. doi: 10.21037/apm-22-1366. Epub 2024 Apr 28.

Abstract

BACKGROUND AND OBJECTIVE

The World Health Organization endorses that palliative care has a significant impact on the outcomes of patients with cancer. Integration of palliative care into standard oncology practice has been shown to improve a variety of patient outcomes. In this article, we present our experience with the development of a palliative care tumor board.

METHODS

Starting in June 2021, we implemented a multidisciplinary palliative care and oncology tumor board focused on pain and symptom management. Complex cases were presented bimonthly. We retrospectively reviewed our experience. Data were collected on the attendees, the case presented, and the resultant therapeutic decisions made.

KEY CONTENT AND FINDINGS

Between June 2021 and September 2022, tumor board meetings were conducted in person and virtually. An average of twelve people attended, including physicians and nurse practitioners from the palliative care, oncology, interventional radiology, radiation oncology, psychiatry, pediatric palliative care, and physical medicine and rehab disciplines. There were 68 patients presented with the most frequently discussed cancer being breast cancer, followed by lung cancer. A total of 18 patients (26%) were referred for procedure, including 7 patients (10%) for radiation and 11 patients (16%) for interventional procedures, and 34 patients (50%) had medication changes as outcomes of the meeting.

CONCLUSIONS

The development of a biweekly palliative care conference modeled after traditional oncologic tumor board meetings allows patients to be discussed in a multidisciplinary setting and commonly results in changes in the management for pain and other cancer-related symptoms.

摘要

背景与目的

世界卫生组织认可姑息治疗对癌症患者的结局具有重要影响。姑息治疗融入标准肿瘤学实践已被证明可以改善各种患者结局。本文介绍了我们在姑息治疗肿瘤委员会发展方面的经验。

方法

从 2021 年 6 月开始,我们实施了一个多学科姑息治疗和肿瘤学肿瘤委员会,重点关注疼痛和症状管理。复杂病例每两个月提出一次。我们对经验进行了回顾性审查。收集的数据包括参会者、提出的病例和做出的治疗决策。

主要内容和发现

在 2021 年 6 月至 2022 年 9 月期间,肿瘤委员会会议以现场和虚拟方式进行。平均有 12 人参加,包括姑息治疗、肿瘤学、介入放射学、放射肿瘤学、精神病学、儿科姑息治疗和物理医学与康复等领域的医生和护士从业者。共有 68 名患者接受了讨论,最常讨论的癌症是乳腺癌,其次是肺癌。共有 18 名患者(26%)被推荐进行手术,包括 7 名(10%)接受放疗和 11 名(16%)接受介入手术,34 名(50%)患者因会议结果改变了药物治疗。

结论

按照传统肿瘤学肿瘤委员会会议模式建立的双周一次姑息治疗会议可以使患者在多学科环境中进行讨论,通常会导致疼痛和其他癌症相关症状管理的改变。

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