Current Opinion in Supportive and Palliative Care最新文献_第9页

Neurosurgical interventions for cancer pain. 癌症疼痛的神经外科干预。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-06-01 Epub Date: 2023-04-06 DOI: 10.1097/SPC.0000000000000642

Alexander Alamri, Abteen Mostofi, Erlick Ac Pereira

{"title":"Neurosurgical interventions for cancer pain.","authors":"Alexander Alamri, Abteen Mostofi, Erlick Ac Pereira","doi":"10.1097/SPC.0000000000000642","DOIUrl":"10.1097/SPC.0000000000000642","url":null,"abstract":"Purpose of review: Half of all cancer patients will develop cancer-related pain, and a fifth of these patients will continue to experience pain refractory to maximal pharmacological therapy. This, together with the opioid crisis, has prompted a resurgence in neurosurgical treatments. Neuromodulatory or neuroablative procedures are largely used for various nonmalignant, chronic pain conditions, but there is growing evidence to support their use in cancer pain. This review aims to cover the main neurosurgical treatments that may prove useful in the changing sphere of cancer pain treatment.Recent findings: Neuromodulation techniques for pain have largely replaced neuroablation in neurosurgical practice due to the higher risk of inadvertent permanent neurological deficits from the latter. When compared to neuroablative approaches for severe treatment-refractory cancer pain, neuromodulation is more expensive (largely due to implant cost) and requires more follow-up, with greater engagement needed from the health service, the patient and their carers. Furthermore, neuroablation has a more rapid onset of effect.Summary: Neuromodulation techniques for pain have largely replaced neuroablation in neurosurgical practice due to the higher risk of inadvertent permanent neurological deficits from the latter. Whilst this approach is beneficial when treating nonmalignant pain, neuromodulation in patients with pain related to advanced cancer still has a limited role. Neuroablative procedures are less expensive, require less follow-up, and can have a lower burden on health services, patients and their carers.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9836796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-06-01 Epub Date: 2023-04-26 DOI: 10.1097/SPC.0000000000000647

引用次数: 0

Survival prediction in advanced cancer patients - a narrative review. 晚期癌症患者的生存预测——叙述性综述。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-06-01 Epub Date: 2023-04-06 DOI: 10.1097/SPC.0000000000000643

Shing Fung Lee, Charles B Simone

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-03-01 Epub Date: 2023-01-26 DOI: 10.1097/SPC.0000000000000632

引用次数: 0

A shift from simple to sophisticated: using intensity-modulated radiation therapy in conventional nonstereotactic palliative radiotherapy. 从简单到复杂的转变：在传统的非过敏性姑息放射治疗中使用调强放射治疗。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-03-01 Epub Date: 2023-01-20 DOI: 10.1097/SPC.0000000000000639

Kristopher Dennis, Kelly Linden, Marc Gaudet

{"title":"A shift from simple to sophisticated: using intensity-modulated radiation therapy in conventional nonstereotactic palliative radiotherapy.","authors":"Kristopher Dennis, Kelly Linden, Marc Gaudet","doi":"10.1097/SPC.0000000000000639","DOIUrl":"10.1097/SPC.0000000000000639","url":null,"abstract":"Purpose of review: The authors aimed to highlight trends in, and evidence underlying the use of highly conformal radiotherapy (RT) techniques in conventional nonstereotactic palliative RT. The authors reviewed palliative-intent and curative-intent studies relevant to the use of intensity-modulated radiation therapy (IMRT) for the delivery of nonstereotactic conventional regimens to the brain, head and neck, thorax, abdomen and pelvis, and bone metastases.Recent findings: The use of IMRT has become standard with certain indications for brain metastases such as hippocampus-avoiding/limiting whole brain RT. IMRT in the treatment of bone metastases is increasing at many institutions despite limited data comparing its effectiveness with that of fluoroscopy-based and three-dimensional conformal radiation therapy techniques. There is scant data describing the use of IMRT for palliation in other extracranial anatomic sites; guidance for its use in these settings must be gleaned almost exclusively from curative-intent randomized trials, consensus recommendations and contouring atlases.Summary: Consistent with historical technology shifts in RT practice, the uptake of highly conformal techniques such as IMRT for conventional palliative RT will likely outpace rigorous evaluations of their advantages and disadvantages relative to simpler techniques. Opportunities exist in virtually all anatomic sites for observational and randomized studies to evaluate the clinical impacts of these modern techniques in the palliative setting.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9521709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

The impact of ageism in the care of older adults with cancer. 年龄歧视对老年癌症患者护理的影响。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-03-01 DOI: 10.1097/SPC.0000000000000629

Michael Krasovitsky, Isobel Porter, Gina Tuch

{"title":"The impact of ageism in the care of older adults with cancer.","authors":"Michael Krasovitsky, Isobel Porter, Gina Tuch","doi":"10.1097/SPC.0000000000000629","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000629","url":null,"abstract":"Purpose of review: This review summarizes recent research on the impact of ageism in older adults with cancer and how society can best address the issue. Despite older individuals representing the vast majority of those with cancer, with a dramatic increase in incidence anticipated in the coming decades, ageism remains an under-recognized and extremely detrimental phenomenon in cancer care.Recent findings: We examine the associations between ageism and health, and highlight the consequences of higher mortality, a deterioration in mental and physical health, worse functional status and increased comorbidity burden. We then discuss the oncologic-specific impacts of ageism, including lower rates of cancer screening, decreased histological confirmation of cancer, decreased surgical intervention and systemic therapy prescription and poorer survivorship experience. To conclude, we illustrate the opportunities within oncologic systems of care to engage with, and dismantle, the damaging effects of ageism, namely policy and legislation, education and intergenerational contact.Summary: Despite recognition of the numerous negative sequelae of ageism, there remains a paucity of literature regarding the intersection between ageism and cancer. Our piece summarizes the key developments in this field, but further evaluation is desperately required.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9167651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Geriatric assessment and treatment decision-making in surgical oncology. 外科肿瘤学中的老年评估和治疗决策。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-03-01 Epub Date: 2023-01-20 DOI: 10.1097/SPC.0000000000000635

Tyler R Chesney, Julian F Daza, Camilla L Wong

{"title":"Geriatric assessment and treatment decision-making in surgical oncology.","authors":"Tyler R Chesney, Julian F Daza, Camilla L Wong","doi":"10.1097/SPC.0000000000000635","DOIUrl":"10.1097/SPC.0000000000000635","url":null,"abstract":"Purpose of review: Present an approach for surgical decision-making in cancer that incorporates geriatric assessment by building upon the common categories of tumor, technical, and patient factors to enable dual assessment of disease and geriatric factors.Recent findings: Conventional preoperative assessment is insufficient for older adults missing important modifiable deficits, and inaccurately estimating treatment intolerance, complications, functional impairment and disability, and death. Including geriatric-focused assessment into routine perioperative care facilitates improved communications between clinicians and patients and among interdisciplinary teams. In addition, it facilitates the detection of geriatric-specific deficits that are amenable to treatment. We propose a framework for embedding geriatric assessment into surgical oncology practice to allow more accurate risk stratification, identify and manage geriatric deficits, support decision-making, and plan proactively for both cancer-directed and non-cancer-directed therapies. This patient-centered approach can reduce adverse outcomes such as functional decline, delirium, prolonged hospitalization, discharge to long-term care, immediate postoperative complications, and death.Summary: Geriatric assessment and management has substantial benefits over conventional preoperative assessment alone. This article highlights these advantages and outlines a feasible strategy to incorporate both disease-based and geriatric-specific assessment and treatment when caring for older surgical patients with cancer.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9521706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Interventions to improve nutritional status for older patients with cancer - a holistic approach is needed. 干预措施，以改善老年癌症患者的营养状况-需要一个整体的方法。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-03-01 DOI: 10.1097/SPC.0000000000000630

Gabor Liposits, Surbhi Singhal, Jessica L Krok-Schoen

{"title":"Interventions to improve nutritional status for older patients with cancer - a holistic approach is needed.","authors":"Gabor Liposits, Surbhi Singhal, Jessica L Krok-Schoen","doi":"10.1097/SPC.0000000000000630","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000630","url":null,"abstract":"Purpose of review: Older adults with cancer frequently experience malnutrition and sarcopenia resulting in lower treatment efficacy, increased risk of toxicities and healthcare costs, lower quality of life and shorter survival. Improving nutritional status in this rapidly growing population is an urgent need globally. We reviewed randomized controlled trials from the last 18 months focusing on nutritional status and applying multimodal interventions in older adults with cancer.Recent findings: Several randomized controlled trials have been reported recently elucidating the impact of nutritional interventions as a part of multimodal interventions through different stages of cancer care. Although multimodal interventions rarely demonstrate survival benefit, they improve several important aspects of cancer care, including patient-centred endpoints such as physical functioning, adherence, patient satisfaction and quality of life.Summary: Multimodal interventions including nutrition have the potential to improve patient-centred outcomes in older adults with cancer during the continuum of care, from prehabilitation to palliative care. Early, integrated supportive care applying the right intervention in the right setting at the proper time along with personalized antitumor treatment is the cornerstone of optimal holistic cancer care.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9521705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Burnout of healthcare professionals in supportive and palliative care: a summary of recent literature. 支持性和姑息性医疗保健专业人员的倦怠：近期文献综述。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-03-01 Epub Date: 2023-01-20 DOI: 10.1097/SPC.0000000000000638

Eva Oldenburger, Maaike L De Roo

{"title":"Burnout of healthcare professionals in supportive and palliative care: a summary of recent literature.","authors":"Eva Oldenburger, Maaike L De Roo","doi":"10.1097/SPC.0000000000000638","DOIUrl":"10.1097/SPC.0000000000000638","url":null,"abstract":"Purpose of review: Burnout is a complex phenomenon where several personal and work-related factors interact with each other. Palliative care is a challenging branch of healthcare, which can be especially demanding for the professionals providing it. This review presents an overview of the most recent literature on causes, identification, and consequences of burnout as well as articles on interventions to reduce burnout in the professional palliative healthcare provider setting.Recent findings: With a few exceptions, research on burnout in the palliative care provider setting is focused on further insight on the different aspects that cause burnout on an individual, social, and organizational level. Unfortunately, only a few studies were found on interventions to prevent burnout. While the results of these interventions were promising, long-term results or data on how these diminish actual healthcare provider dropout were not available.Summary: Research on burnout faced by palliative healthcare professionals seems to focus mainly on gaining further insight of different aspects of the complex syndrome that is burnout and how different individual, social, and organizational factors interact with each other. Further research on the prevention and treatment of burnout is necessary.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9521708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of oncology pharmacists and comprehensive medication reconciliation in informing treatment plans for older adults with cancer and downstream outcomes. 肿瘤药师和综合药物调解在告知老年癌症治疗计划和下游结果中的作用。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-03-01 DOI: 10.1097/SPC.0000000000000634

Andrew Whitman, Emily Fitch, Ginah Nightingale

{"title":"The role of oncology pharmacists and comprehensive medication reconciliation in informing treatment plans for older adults with cancer and downstream outcomes.","authors":"Andrew Whitman, Emily Fitch, Ginah Nightingale","doi":"10.1097/SPC.0000000000000634","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000634","url":null,"abstract":"Purpose of review: Proper medication management is an essential part of older adult cancer care. An aging population, an increase in anticancer treatment options, and high rates of comorbid conditions make navigating general medication reconciliation complicated. This review will highlight the recent literature describing the roles of the oncology pharmacist in caring for older adults with cancer.Recent findings: The body of literature highlighting oncology pharmacist roles in this population is mainly focused on polypharmacy and potentially inappropriate medication assessments, deprescribing nonessential therapies, drug-drug interaction reviews, and immunization optimization. Outcomes associated with oncology pharmacist interventions are still lacking as well as the development of benchmarks for appropriate pharmacy-based care in the older adult oncology population.Summary: Oncology pharmacist interventions in older adults with cancer have the potential to improve patient care. Future randomized studies in this area of practice are warranted in order to clearly define the optimal impact of oncology pharmacists.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9521707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3