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Therapeutic Massage for Psychological Well-being in Geriatric Oncology
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新たに診断された悪性結晶腫の成人のケアパターン
Susan M Chang1, Ian F Parney, Wei Huang
1Department of Neurological Surgery, University of California, San Francisco, CA 94143-0350, USA. changs@neurosurg.ucsf.edu
JAMA
|February 3, 2005
まとめ
この研究は,悪性結晶腫患者の様々な治療パターンを強調し,MRI,外科手術,放射線の一般的な使用,しかしめったに化学療法を使用しないことに注意しています. 抗薬の頻繁な使用はガイドラインに反しており,更新された臨床ガイドラインの必要性を示唆しています.
科学分野:
- 神経腫瘍学 神経腫瘍学
- クリニカル・プラクティスのパターン
- 根拠に基づいた医学は,証拠に基づいた医療です.
背景:
- 悪性膠原腫 (III級またはIV級) 患者は,限られた証拠に基づいた治療ガイドラインで,予後が悪い.
- これらの患者のケアパターンの将来的なデータは稀です.
研究 の 目的:
- ガン性膠原腫のケアにおける個々の実践パターンとアウトカムを比較するためのベンチマークデータを確立する.
- 学術環境とコミュニティ環境の間の治療アプローチの違いを特定する.
主な方法:
- グリオマアウトカムズ (GO) プロジェクトでは,新たに診断された第3級または第4級プライマリグリオマの成人患者565人が登録されました.
- データ収集は,入学時のアンケート,手術前期,および最大24ヶ月の3ヶ月のフォローアップで行われました.
- 分析は,外科的管理,手術前および手術後の管理を含むケアパターンに焦点を当てました.
主要な成果:
- 磁気共鳴画像 (92%) と腫瘍切除 (75%) が一般的であった. 皮質マッピング (19%) と画像ガイド (29%) のような外科的補助は稀でした.
- 術後のコルチコステロイド (99%) と抗薬 (88%) が広く使用され,抗うつ薬 (8%) と予防ヘパリン (7%) はまれであった.
- 補助放射線療法 (87%) は一般的であり,化学療法 (54%) はよりまれであった. 学術環境とコミュニティ環境の間には,重要な実践の違いが存在しました.
結論:
- 現在の実践は,MRI,外科手術,放射線治療に大きく依存しており,一般的な受け入れと一致しています.
- 化学療法の頻繁な使用は文献と矛盾し,通常の抗薬の使用はガイドラインと矛盾する可能性があります.
- 手術補助薬,予防ヘパリン,抗うつ薬に関するさらなる研究が必要である. 臨床ガイドラインの確立は,実践の変動性を減らすことができます.
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