由于外围神经病变,患者对改变化疗治疗的看法
Daniel L Hertz1, Cindy Tofthagen2, Emanuela Rossi3
1Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Room 2560C, Ann Arbor, MI, 48109-1065, USA. DLHertz@med.umich.edu.
概括
接受化疗的患者希望讨论化疗诱导的周围神经病变 (CIPN) 的治疗变化. 他们优先考虑症状的持续性和与临床医生共享决策,以管理风险和益处.
科学领域:
- 在瘤学瘤学.
- 神经科学是一个神经科学.
- 患者报告的结果
背景情况:
- 临床指南建议修改神经毒性化疗,以治疗不能忍受的化疗诱导的外围神经病变 (CIPN).
- 了解患者对治疗改变的看法对于管理CIPN至关重要.
- 平衡治疗疗效与不可逆转的CIPN风险是一个关键的临床挑战.
研究的目的:
- 调查接受神经毒性化疗的患者,了解他们对治疗改变的看法.
- 评估患者对预防不可逆转的CIPN与降低治疗疗效的看法.
- 探索患者对化疗修改决定的偏好.
主要方法:
- 一个横截面的在线调查分发给正在接受或曾经接受神经毒性化疗的患者.
- 用描述性和定性统计方法分析了447名参与者的数据.
- 该调查重点关注患者对CIPN的体验及其决策过程.
主要成果:
- 在一年前完成治疗的患者中,很大一部分 (45%) 没有报告CIPN症状的缓解.
- 与暂时症状相比,患者表示更愿意停止永久性,不那么严重的CIPN的化疗.
- 与临床医生共同决策是很常见的 (61%),尽管对治疗改变的恐惧阻止了一些患者和临床医生的关于CIPN的沟通.
结论:
- 在考虑由于CIPN而改变神经毒性化疗时,共享决策至关重要,权衡长期利益和风险.
- 需要改善患者对CIPN症状,永久性和临床医生同情心的教育.
- 开发决策辅助工具和沟通工具对于加强癌症患者的共同决策至关重要.
更多相关视频
相关概念视频
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
167
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
167
01:29Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
298
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
298
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
208
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
208
01:21Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
281
Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...
281
01:27Nursing Ethical Principles II
982
Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
982
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
838
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
838