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肿瘤支持治疗范畴、模式与发展

  • 石汉平 ,
  • 2于世英 ,
  • 3巴一 ,
  • 4唐丽丽 ,
  • 5李薇
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  • 1首都医科大学附属北京世纪坛医院胃肠外科 / 临床营养科,北京 100038;2华中科技大学附属同济医院,武汉 430030;3天津医科大学肿瘤医院,天津 300100;4北京大学肿瘤医院,北京 100142;5吉林大学第一医院,长春 130021

网络出版日期: 2021-04-12

基金资助

国家重点研发计划项目(2017YFC1309200)

Scope, model and development of supportive care for cancer

  • SHI Han-ping ,
  • YU Shi-ying ,
  • BA Yi ,
  • TANG Li-li ,
  • LI Wei
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  • 1Department of Gastrointestinal Surgery / Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; 2Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan 430030, China; 3Tianjin Medical University Cancer Institute and Hospital, Tianjin 300100, China; 4Beijing Cancer Hospital, Peking University, Beijing 100142, China; 5The First Hospital of Jilin University, Changchun 130021, China

Online published: 2021-04-12

摘要

肿瘤支持治疗是与手术、放疗、化疗并重的肿瘤基本治疗方法,是典型的多学科协作模式。理想的肿瘤支持治疗团队组成应该是PRN,即由医生(physician,P)、心理学家(psychologist,P)、药师(pharmacist,P)、康复治疗师(rehabilitation therapist,R)及宗教工作者(religious worker,R)、营养学家(nutritionist,N)、护士(nurse,N)组成。支持治疗是整合医学的典范,其内容非常丰富,主要包括灵性慰籍(spiritual,S)、药物(症状)治疗(pharmacologic,P)、运动治疗(exercise,E)、营养治疗(nutrition,N)、沟通交流(communication,C)、情感梳理(emotion,E)、康复(rehabilitation,R)等7个方面,简称为SPENCER。我国目前存在3种不同的支持治疗运作模式:①独立治疗模式;②联合治疗模式;③整合治疗模式。大型肿瘤专科医院以独立治疗模式为主,综合医院肿瘤中心以联合治疗模式为主,尽管整合治疗模式可能是一个更好的发展方向,但三位一体可能更加符合我国国情。肿瘤支持治疗的重要作用已经得到大量研究证明。轻视支持治疗是我国肿瘤患者总体生活质量及生存率低下的一个重要原因之一。因此,我们必须改变落后观念,
高度重视肿瘤支持治疗。

关键词: 肿瘤; 支持治疗; 范畴; 模式

本文引用格式

石汉平 , 2于世英 , 3巴一 , 4唐丽丽 , 5李薇 . 肿瘤支持治疗范畴、模式与发展[J]. 肿瘤代谢与营养电子杂志, 2018 , 5(4) : 333 -336 . DOI: 10.16689/j.cnki.cn11-9349/r.2018.04.001

Abstract

Abstract: Supportive care is a typical multidisciplinary model for basic cancer treatment that shares the same level importance as surgery, radiotherapy and chemotherapy. Ideally, a supportive care team consists of physicians, psychologists, pharmacists, rehabilitation therapists, religious workers, nutritionists, and nurses (acronym: PRN). Supportive care is representative for integrated medical services with care from aspects of spiritual, pharmacologic treatment, exercise, nutritional support, communication, emotion, and rehabilitation, with a acronym of SPENCER. There are three distinct models for supportive care in China, namely solo practice model, congress practice model and integrated care model. Solo practice model is the major model utilized in large-scale cancer specialized hospitals while congress practice model is often employed in general hospitals. Although integrated care may be a better direction for supportive care development, a three-in-one model may even better meet clinical need. The efficacy of supportive care is evident in various researches, and the underestimation of supportive care may be one of the reasons for the low survival rate and low quality of life among Chinese patients. Therefore, supportive care for cancer patients should be emphasized as one of the basic treatment for cancer.

Key words: Cancer; Supportive care; Scope; Model

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