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JCO：晚期肿瘤患者心理干预

2018-07-01 MedSci MedSci原创

晚期肿瘤心理干预临床试验
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晚期肿瘤患者通常会因为疾病负担和即将面临的死亡而出现持续的压力增加。管理肿瘤并有意义的生活（CALM）是一种简洁的人性化的心理治疗措施，主要用于预防和治疗晚期肿瘤患者面临的死亡压力。JCO近期发表了一篇文章，比较CALM和常规护理（UC）在晚期肿瘤患者中的效果。

晚期肿瘤患者通常会因为疾病负担和即将面临的死亡而出现持续的压力增加。管理肿瘤并有意义的生活（CALM）是一种简洁的人性化的心理治疗措施，主要用于预防和治疗晚期肿瘤患者面临的死亡压力。JCO近期发表了一篇文章，比较CALM和常规护理（UC）在晚期肿瘤患者中的效果。

研究纳入的晚期肿瘤患者来自肿瘤中心的门诊。患者随机分为CALM联合UC或单纯UC治疗组。主要的研究结果为抑郁症状和肿瘤相关压力的评估。次要的研究结果在基线，3个月（主要终点）和6个月（试验终点）进行评估。从2012年2月3日至2016年3月4日，研究共纳入305例患者。随机分为CALM组（n=151）或UC组（n=154）。在3个月和6个月，CALM组患者报告的抑郁症状严重程度轻于UC组患者。6个月时，CALM组患者的临终准备也显着优于UC组患者。未发现不良反应。

文章最后认为，CALM是一项有效的心理干预措施，可以缓解晚期肿瘤患者的抑郁症状并使患者对即将面对的结果有更好的准备。

原始出处：

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    2018-12-29 ms705947299214030

    #晚期肿瘤#

    0

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    2018-07-04 lidong40

    #JCO#

    0

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    2018-07-03 lanyan20020087

    #肿瘤患者#

    0

  4. 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    2018-07-02 phoebeyan520

    谢谢分享学习之

    0

  5. 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    2018-07-02 wuqianhong99

    CALM组效果明显

    0

  6. 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channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:04 CST 2018, time=2018-07-01, status=1, ipAttribution=)]
    2018-07-02 飛歌

    厉害了我的哥

    0

  7. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:37 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328574, encodeId=45833285e418, content=主要的研究结果为抑郁症状和肿瘤相关压力的评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:18 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328573, encodeId=79b73285e3a3, content=CALM和常规护理(UC)在晚期肿瘤患者中的效果., beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:04 CST 2018, time=2018-07-01, status=1, ipAttribution=)]
    2018-07-01 随梦飞扬

    6个月时.CALM组患者的临终准备也显着优于UC组患者.未发现不良反应.

    0

  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Mon Jul 02 00:19:59 CST 2018, time=2018-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328576, encodeId=43083285e607, content=6个月时.CALM组患者的临终准备也显着优于UC组患者.未发现不良反应., beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:49 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328575, encodeId=b5e33285e579, content=在3个月和6个月.CALM组患者报告的抑郁症状严重程度轻于UC组患者., beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:37 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328574, encodeId=45833285e418, content=主要的研究结果为抑郁症状和肿瘤相关压力的评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:18 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328573, encodeId=79b73285e3a3, content=CALM和常规护理(UC)在晚期肿瘤患者中的效果., beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:04 CST 2018, time=2018-07-01, status=1, ipAttribution=)]
    2018-07-01 随梦飞扬

    在3个月和6个月.CALM组患者报告的抑郁症状严重程度轻于UC组患者.

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1709465, encodeId=08e21e094657a, content=<a href='/topic/show?id=cf4a598e795' target=_blank style='color:#2F92EE;'>#晚期肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59877, encryptionId=cf4a598e795, topicName=晚期肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=926b31711313, createdName=ms705947299214030, createdTime=Sat Dec 29 14:32:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1891525, encodeId=e3a51891525e6, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Wed Jul 04 07:32:00 CST 2018, time=2018-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1424246, encodeId=bd8b142424647, content=<a href='/topic/show?id=94c182929d0' target=_blank style='color:#2F92EE;'>#肿瘤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82929, encryptionId=94c182929d0, topicName=肿瘤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60943920553, createdName=lanyan20020087, createdTime=Tue Jul 03 12:32:00 CST 2018, time=2018-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328598, encodeId=d0543285985f, content=谢谢分享学习之, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Mon Jul 02 01:57:07 CST 2018, time=2018-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328587, encodeId=97fc32858e61, content=CALM组效果明显, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/12/6f80f6d18bfb74ecb66b6ced313da725.jpg, createdBy=61d639722, createdName=wuqianhong99, createdTime=Mon Jul 02 00:51:15 CST 2018, time=2018-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328580, encodeId=1dc932858025, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Mon Jul 02 00:19:59 CST 2018, time=2018-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328576, encodeId=43083285e607, content=6个月时.CALM组患者的临终准备也显着优于UC组患者.未发现不良反应., beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:49 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328575, encodeId=b5e33285e579, content=在3个月和6个月.CALM组患者报告的抑郁症状严重程度轻于UC组患者., beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:37 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328574, encodeId=45833285e418, content=主要的研究结果为抑郁症状和肿瘤相关压力的评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:18 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328573, encodeId=79b73285e3a3, content=CALM和常规护理(UC)在晚期肿瘤患者中的效果., beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:04 CST 2018, time=2018-07-01, status=1, ipAttribution=)]
    2018-07-01 随梦飞扬

    主要的研究结果为抑郁症状和肿瘤相关压力的评估.

    0

  10. 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createdName=phoebeyan520, createdTime=Mon Jul 02 01:57:07 CST 2018, time=2018-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328587, encodeId=97fc32858e61, content=CALM组效果明显, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/12/6f80f6d18bfb74ecb66b6ced313da725.jpg, createdBy=61d639722, createdName=wuqianhong99, createdTime=Mon Jul 02 00:51:15 CST 2018, time=2018-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328580, encodeId=1dc932858025, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Mon Jul 02 00:19:59 CST 2018, time=2018-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328576, encodeId=43083285e607, content=6个月时.CALM组患者的临终准备也显着优于UC组患者.未发现不良反应., beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:49 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328575, encodeId=b5e33285e579, content=在3个月和6个月.CALM组患者报告的抑郁症状严重程度轻于UC组患者., beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:37 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328574, encodeId=45833285e418, content=主要的研究结果为抑郁症状和肿瘤相关压力的评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:18 CST 2018, time=2018-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=328573, encodeId=79b73285e3a3, content=CALM和常规护理(UC)在晚期肿瘤患者中的效果., beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jul 01 23:59:04 CST 2018, time=2018-07-01, status=1, ipAttribution=)]
    2018-07-01 随梦飞扬

    CALM和常规护理(UC)在晚期肿瘤患者中的效果.

    0

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对于晚期肿瘤患者的治疗通常是姑息性的。不可治愈的晚期肿瘤患者的治疗应平衡生存时间及最大化生活质量之间的关系。不断增加的住院次数被认为是晚期肿瘤患者病情管理不良的标志。JCO近期发表了一篇文章，研究晚期肿瘤患者诊断后1年住院率以及个体水平和医院水平再入院的预测因素。

CLIN CANCER RES：LY2940680治疗晚期肿瘤

CLIN CANCER RES近期发表了一篇文章，研究LY2940680（taladegib）治疗局部晚期/转移肿瘤患者的推荐Ⅱ期剂量及安全的给药方案。

JAMA Intern Med：粪便免疫化学试验用于结肠癌风险评估

粪便免疫化学试验对于平均风险以上结肠癌患者的患癌风险检测表现出较高的准确性，但对于其他类型的晚期肿瘤的检测能力适中

CLIN CANCER RES：TAK-117治疗晚期恶性肿瘤Ⅰ期临床试验结果

CLIN CANCER RES近期发表了一篇文章，报道了PI3Kα选择抑制剂TAK-117治疗晚期恶性实体肿瘤的安全性，最大耐受剂量，药代动力学，药理学以及抗肿瘤活性等Ⅰ期临床试验结果。

CLIN CANCER RES：Utomilumab单药治疗晚期肿瘤

动物模型中进行的临床前实验证明免疫共刺激分子4-1BB/CD137的激动剂可以增强细胞毒T细胞和NK细胞的活性，诱导有力的抗肿瘤反应。Utomilumab（PF-05082566）是免疫共刺激分子4-1BB/CD137的激动性单抗。CLIN CANCER RES近期发表了一篇文章，评估Utomilumab治疗晚期恶性肿瘤的安全性、耐受性、药代动力学和药效学。

病例分享：这例结核病人险些被误诊为晚期肿瘤？PET-CT和T-SPOT为何会同时出现假阳性？

患者入院时，初步判断为急性支气管炎，经多科室讨论及全身PET-CT检查后，怀疑为左肾癌并双肺及胸膜多发转移——晚期肿瘤？ 但综合临床症状，最终诊断为「结核病」，经治疗，患者的发热症状很快得以缓解。回头梳理这份病例，我们能得到哪些启发？

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