为接受免疫检查点抑制剂治疗的患者提供肿瘤初级护理。

IF 2.5 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL American Journal of Medicine Pub Date : 2024-08-27 DOI:10.1016/j.amjmed.2024.08.025
Christopher J Hoimes, Suzanne McGettigan, Lee Schwartzberg
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引用次数: 0

摘要

基层临床医生与患者建立长期关系,并在癌症患者的治疗过程中发挥关键作用。基层临床医生是多学科团队的重要成员,在协调和提供支持性护理方面发挥着核心作用。在辅助/新辅助治疗和转移性疾病中使用免疫检查点抑制剂需要了解其长期生存益处和免疫相关不良事件(irAEs)。基层临床医生应与肿瘤护理团队合作,提高对 irAE 的认识,并确定管理 irAE 的制度化和个性化方法。免疫不良事件可在任何时间发生,并表现出一系列症状,因此很难将其与其他疾病区分开来。非器质性病变的处理有赖于早期识别、密切监测以及使用皮质类固醇和/或中断剂量进行干预。延迟性 IrAE 强调了治疗后继续保持临床警惕的重要性,因为基层临床医生是患者最持久的接触点。基层临床医生在支持癌症患者的护理以及确保识别、监测和干预适当的 irAE 方面起着至关重要的作用。长期持续的护理对于免疫肿瘤患者的治疗至关重要。
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Onco-Primary Care of Patients Receiving Immune Checkpoint Inhibitors.

Primary clinicians foster long-term relationships with patients and play key roles in the treatment journey for patients with cancer. Primary clinicians are important members of the multidisciplinary team and are central in coordinating and providing supportive care. The use of immune checkpoint inhibitors in adjuvant/neoadjuvant treatments and metastatic disease requires an awareness of their long-term survival benefits and immune-related adverse events (irAEs). Primary clinicians collaborate with the oncology care team to increase irAE awareness and identify institutional and individualized approaches to manage irAEs. IrAEs can develop at any time and present with a spectrum of symptoms, making them difficult to differentiate from other conditions. IrAE management relies on early recognition, close monitoring, and intervention with corticosteroids and/or dose interruption. Delayed irAEs underscore the importance of continued clinical vigilance following treatment, as primary clinicians are patients' most enduring point of contact. Primary clinicians have a critical role in supporting the care of patients with cancer and ensuring appropriate irAE recognition, monitoring, and intervention. Long-term continuity of care is critical for the immuno-oncology patient journey.

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来源期刊
American Journal of Medicine
American Journal of Medicine 医学-医学:内科
CiteScore
6.30
自引率
3.40%
发文量
449
审稿时长
9 days
期刊介绍: The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice. AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than 125 medical schools across the U.S. Each issue carries useful reviews as well as seminal articles of immediate interest to the practicing physician, including peer-reviewed, original scientific studies that have direct clinical significance and position papers on health care issues, medical education, and public policy.
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