ステージ1臨床試験における進行がん患者に対する緩和医療のマッピング: スコーピングレビュー
Diego Candelmi1,2,3, Alazne Belar2,3, Carla Zapata Del Mar1,4
1Palliative Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain.
Palliative medicine
|September 5, 2025
まとめ
癌の第1段階試験では 先進的な治療法がありますが 総合的な緩和ケアが必要です このレビューは患者のニーズと統合の課題を強調し,腫瘍学試験における専門的な緩和ケアを求めています.
科学分野:
- 腫瘍学
- 緩和ケア
- 臨床試験 研究
背景:
- 1期がん臨床試験は,標準治療に反応しない進行がんに対する新しい治療法を提供します.
- これらの試験の患者は,実験的治療法との潜在的な目標の衝突のために,しばしば満たされない重要な緩和ケアを必要としています.
- 生活の質は緩和ケアにおける重要な関心事であり,攻撃的ながん治療の文脈で誤解されることがあります.
研究 の 目的:
- 第1段階がん臨床試験における緩和ケア提供と統合に関する既存の文献を体系的に検討し,マッピングする.
- 実験的ながん治療を受けている患者の緩和ケアに関する知識のギャップを特定する.
- 早期腫瘍学試験における緩和ケアを最適化するための将来の研究方向性を説明する.
主な方法:
- 体系的なスコーピングレビューの方法が採用されました.
- 2003年から2023年の間に発表された研究について,複数のデータベース (PubMed,Web of Science,Scopus,CINAHL,PsycINFO,Google Scholar) で検索を行った.
- このレビューは,第1相臨床試験に登録された進行がん患者に関する研究に焦点を当てた.
主要な成果:
- 50件の研究が含まれており 患者の寿命が短くなり 症状が重くなり ストレスが溜まり 精神的なニーズが満たされていないことが分かりました
- 患者は予後情報や終末期に関する議論に躊躇し,事前にケア計画を立てることを妨げました.
- 終末期の介護は,頻繁に入院,入院中の死亡,ホスピスへの紹介が遅れたことによって特徴付けられ,介護者は苦痛を経験し,医療従事者は統合の障壁に直面しました.
結論:
- このレビューは,がん臨床試験の第1段階における患者および介護者の独特のニーズを強調しています.
- 専門的な緩和ケアを腫瘍学試験に組み込むことは,さらなる調査を必要とする複雑性を持っています.
- 将来の研究では,臨床試験ユニット内の緩和ケアを統合するための標準化されたガイドラインの開発を優先すべきです.
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