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【JAMA】化疗在生命终将结束时的意义？
"When Is Enough, Enough?"
JAMA. 2008;299(22):2667-2678.
Patients face difficult decisions about chemotherapy near the end of life. Such treatment might prolong survival or reduce symptoms but cause adverse effects, prevent the patient from engaging in meaningful life review and preparing for death, and preclude entry into hospice. Palliative care and oncology clinicians should be logical partners in caring for patients with serious cancers for which symptom control, medically appropriate goal setting, and communication are paramount, but some studies have shown limited cooperation. We illustrate how clinicians involved in palliative care and oncology can more effectively work together with the story of Mr L, a previously healthy 56-year-old man, who wanted to survive his lung cancer at all costs. He lived 14 months with 3 types of chemotherapy, received chemotherapy just 6 days before his death, and resisted entering hospice until his prognosis and options were explicitly communicated. Approaches to communication about prognosis and treatment options and questions that patients may want to ask are discussed.
http://jama.ama-assn.org/cgi/content/abstract/299/22/2667 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 The Role of Chemotherapy at the End of Life
"When Is Enough, Enough?"
化疗在终末期患者中的地位“什么时候停止化疗，真的足够了吗？”
JAMA. 2008;299(22):2667-2678.
Patients face difficult decisions about chemotherapy near the end of life. Such treatment might prolong survival or reduce symptoms but cause adverse effects, prevent the patient from engaging in meaningful life review and preparing for death, and preclude entry into hospice. 在终末期患者化疗问题上，患者面临艰难抉择。该治疗可能延长生存期或减轻症状，但同样引起副反应，使患者无法进入临终关怀医院进行有意义的人生回顾、并做好面对死亡的准备。Palliative care and oncology clinicians should be logical partners in caring for patients with serious cancers for which symptom control, medically appropriate goal setting, and communication are paramount, but some studies have shown limited cooperation.对患者严重肿瘤的患者，临终关怀工作者和肿瘤学家本该共同努力控制症状、设定医学上最合适的治疗目标并充分交流，但许多研究显示合作有限。We illustrate how clinicians involved in palliative care and oncology can more effectively work together with the story of Mr L, a previously healthy 56-year-old man, who wanted to survive his lung cancer at all costs. 我们举例说明临床工作者如何更有效地参与临终关怀，这是一个患有有关L先生的故事，他是一个56岁肺癌患者，他不惜一切代价想多活一段时间。He lived 14 months with 3 types of chemotherapy, received chemotherapy just 6 days before his death, and resisted entering hospice until his prognosis and options were explicitly communicated. Approaches to communication about prognosis and treatment options and questions that patients may want to ask are discussed.
他活了14个月，接受了3种化疗方案，在死亡6天前还接受了化疗，他拒绝进入临终关怀医院，直到他明确沟通预后和治疗选择。有关预后和治疗选择的沟通途径及患者关注的问题得到了讨论。
化疗在终末期患者中的地位“什么时候停止化疗，真的足够了吗？”
在终末期患者化疗问题上，患者面临艰难抉择。该治疗可能延长生存期或减轻症状，但同样引起副反应，使患者无法进入临终关怀医院进行有意义的人生回顾、并做好面对死亡的准备。对患者严重肿瘤的患者，临终关怀工作者和肿瘤学家本该共同努力控制症状、设定医学上最合适的治疗目标并充分交流，但许多研究显示合作有限。我们举例说明临床工作者如何更有效地参与临终关怀，这是一个患有有关L先生的故事，他是一个56岁肺癌患者，他不惜一切代价想多活一段时间。他活了14个月，接受了3种化疗方案，在死亡6天前还接受了化疗，他拒绝进入临终关怀医院，直到他明确沟通预后和治疗选择。有关预后和治疗选择的沟通途径及患者关注的问题得到了讨论。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-05-02 05:14
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