临终放射治疗:生活质量和财务毒性考虑

IF 2.6 3区 医学 Q3 ONCOLOGY
Divya Yerramilli , Candice A. Johnstone
{"title":"临终放射治疗:生活质量和财务毒性考虑","authors":"Divya Yerramilli ,&nbsp;Candice A. Johnstone","doi":"10.1016/j.semradonc.2022.11.002","DOIUrl":null,"url":null,"abstract":"<div><p>In patients<span><span> with advanced cancer, radiation therapy<span> is considered at various time points in the patient's clinical course from diagnosis to death. As some patients are living longer with metastatic cancer<span> on novel therapeutics, radiation oncologists are increasingly using radiation therapy as an </span></span></span>ablative therapy<span><span><span> in appropriately selected patients. However, most patients with metastatic cancer still eventually die of their disease. For those without effective targeted therapy options or those who are not candidates for </span>immunotherapy, the time frame from diagnosis to death is still relatively short. Given this evolving landscape, prognostication has become increasingly challenging. Thus, radiation oncologists must be diligent about defining the goals of therapy and considering all </span>treatment<span> options from ablative radiation to medical management and hospice care. The risks and benefits of radiation therapy vary based on an individual patient's prognosis, goals of care, and the ability of radiation to help with their cancer symptoms without undue toxicity over the course of their expected lifetime. When considering recommending a course of radiation, physicians must broaden their understanding of risks and benefits to include not only physical symptoms, but also various psychosocial burdens. These include financial burdens to the patient, to their caregiver and to the healthcare system. The burden of time spent at the end-of-life receiving radiation therapy must also be considered. Thus, the consideration of radiation therapy at the end-of-life can be complex and requires careful attention to the whole patient and their goals of care.</span></span></span></p></div>","PeriodicalId":49542,"journal":{"name":"Seminars in Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Radiation Therapy at the End of-Life: Quality of Life and Financial Toxicity Considerations\",\"authors\":\"Divya Yerramilli ,&nbsp;Candice A. Johnstone\",\"doi\":\"10.1016/j.semradonc.2022.11.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>In patients<span><span> with advanced cancer, radiation therapy<span> is considered at various time points in the patient's clinical course from diagnosis to death. As some patients are living longer with metastatic cancer<span> on novel therapeutics, radiation oncologists are increasingly using radiation therapy as an </span></span></span>ablative therapy<span><span><span> in appropriately selected patients. However, most patients with metastatic cancer still eventually die of their disease. For those without effective targeted therapy options or those who are not candidates for </span>immunotherapy, the time frame from diagnosis to death is still relatively short. Given this evolving landscape, prognostication has become increasingly challenging. Thus, radiation oncologists must be diligent about defining the goals of therapy and considering all </span>treatment<span> options from ablative radiation to medical management and hospice care. The risks and benefits of radiation therapy vary based on an individual patient's prognosis, goals of care, and the ability of radiation to help with their cancer symptoms without undue toxicity over the course of their expected lifetime. When considering recommending a course of radiation, physicians must broaden their understanding of risks and benefits to include not only physical symptoms, but also various psychosocial burdens. These include financial burdens to the patient, to their caregiver and to the healthcare system. The burden of time spent at the end-of-life receiving radiation therapy must also be considered. Thus, the consideration of radiation therapy at the end-of-life can be complex and requires careful attention to the whole patient and their goals of care.</span></span></span></p></div>\",\"PeriodicalId\":49542,\"journal\":{\"name\":\"Seminars in Radiation Oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seminars in Radiation Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1053429622000741\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Radiation Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1053429622000741","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 1

摘要

在晚期癌症患者中,放射治疗是在患者从诊断到死亡的临床过程中的不同时间点考虑的。随着一些转移性癌症患者在新的治疗方法上寿命延长,放射肿瘤学家越来越多地将放射疗法作为消融疗法用于适当选择的患者。然而,大多数转移性癌症患者最终仍然死于疾病。对于那些没有有效靶向治疗选择的人或那些不适合免疫治疗的人来说,从诊断到死亡的时间框架仍然相对较短。鉴于这种不断变化的形势,预测变得越来越具有挑战性。因此,放射肿瘤学家必须认真确定治疗目标,并考虑从消融放射到医疗管理和临终关怀的所有治疗选择。放射治疗的风险和益处取决于个体患者的预后、护理目标以及在其预期寿命内放射治疗在没有过度毒性的情况下帮助其缓解癌症症状的能力。在考虑推荐放射治疗时,医生必须扩大对风险和益处的理解,不仅包括身体症状,还包括各种心理负担。其中包括患者、护理人员和医疗系统的经济负担。还必须考虑到在生命末期接受放射治疗的时间负担。因此,在生命末期考虑放射治疗可能很复杂,需要仔细关注整个患者及其护理目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radiation Therapy at the End of-Life: Quality of Life and Financial Toxicity Considerations

In patients with advanced cancer, radiation therapy is considered at various time points in the patient's clinical course from diagnosis to death. As some patients are living longer with metastatic cancer on novel therapeutics, radiation oncologists are increasingly using radiation therapy as an ablative therapy in appropriately selected patients. However, most patients with metastatic cancer still eventually die of their disease. For those without effective targeted therapy options or those who are not candidates for immunotherapy, the time frame from diagnosis to death is still relatively short. Given this evolving landscape, prognostication has become increasingly challenging. Thus, radiation oncologists must be diligent about defining the goals of therapy and considering all treatment options from ablative radiation to medical management and hospice care. The risks and benefits of radiation therapy vary based on an individual patient's prognosis, goals of care, and the ability of radiation to help with their cancer symptoms without undue toxicity over the course of their expected lifetime. When considering recommending a course of radiation, physicians must broaden their understanding of risks and benefits to include not only physical symptoms, but also various psychosocial burdens. These include financial burdens to the patient, to their caregiver and to the healthcare system. The burden of time spent at the end-of-life receiving radiation therapy must also be considered. Thus, the consideration of radiation therapy at the end-of-life can be complex and requires careful attention to the whole patient and their goals of care.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
5.80
自引率
0.00%
发文量
48
审稿时长
>12 weeks
期刊介绍: Each issue of Seminars in Radiation Oncology is compiled by a guest editor to address a specific topic in the specialty, presenting definitive information on areas of rapid change and development. A significant number of articles report new scientific information. Topics covered include tumor biology, diagnosis, medical and surgical management of the patient, and new technologies.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信