Anderson B
Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Gynecol Oncol. 1994 Dec;55(3 Pt 2):S151-5.
When ovarian cancer progresses, goals change from cure to prolongation of life with the best possible quality for the patient. Criteria for futility must be established to guide the transition from active to palliative management. Pain control can be achieved by following established WHO guidelines. Continued education of the medical community, legislators, and the public is needed to assure pain control for the cancer patient. Limited surgery or radiation can be used to control symptoms from locally progressive disease. Other symptoms to be actively controlled include nausea and vomiting, nutrition, hydration, and fatigue. Support services, including home services, psychological counseling, and nutritional support need funding for both home and hospital settings. Quality of life assessment must be as specific as possible and address the patient's concerns by self-assessment techniques. Funding must be provided to develop specific quality of life tools and to then apply them clinically, both as part of research protocols and to assess success of palliative care.
当卵巢癌病情进展时,治疗目标从治愈转变为尽可能提高患者生活质量以延长生命。必须确立无效治疗的标准,以指导从积极治疗向姑息治疗的转变。遵循世界卫生组织既定指南可实现疼痛控制。需要持续对医学界、立法者和公众进行教育,以确保癌症患者的疼痛得到控制。有限的手术或放疗可用于控制局部进展性疾病的症状。其他需要积极控制的症状包括恶心、呕吐、营养、水合作用和疲劳。包括居家服务、心理咨询和营养支持在内的支持服务在家庭和医院环境中都需要资金支持。生活质量评估必须尽可能具体,并通过自我评估技术解决患者的担忧。必须提供资金来开发特定的生活质量工具,然后将其应用于临床,既作为研究方案的一部分,也用于评估姑息治疗的成效。