肿瘤学急诊和急症：全面回顾

SCI

15 June 2022

Oncologic emergencies and urgencies: A comprehensive review 

(CA Cancer J Clin, IF: 508.7)

• Gould Rothberg Bonnie E,Quest Tammie E,Yeung Sai-Ching J et al. Oncologic emergencies and urgencies: A comprehensive review.[J] .CA Cancer J Clin, 2022, undefined: undefined.

Patients with advanced cancer generate 4 million visits annually to emergency departments (EDs) and other dedicated, high-acuity oncology urgent care centers. Because of both the increasing complexity of systemic treatments overall and the higher rates of active therapy in the geriatric population, many patients experiencing acute decompensations are frail and acutely ill. This article comprehensively reviews the spectrum of oncologic emergencies and urgencies typically encountered in acute care settings. Presentation, underlying etiology, and up-to-date clinical pathways are discussed. Criteria for either a safe discharge to home or a transition of care to the inpatient oncology hospitalist team are emphasized. This review extends beyond familiar conditions such as febrile neutropenia, hypercalcemia, tumor lysis syndrome, malignant spinal cord compression, mechanical bowel obstruction, and breakthrough pain crises to include a broader spectrum of topics encompassing the syndrome of inappropriate antidiuretic hormone secretion, venous thromboembolism and malignant effusions, as well as chemotherapy-induced mucositis, cardiomyopathy, nausea, vomiting, and diarrhea. Emergent and urgent complications associated with targeted therapeutics, including small molecules, naked and drug-conjugated monoclonal antibodies, as well as immune checkpoint inhibitors and chimeric antigen receptor T-cells, are summarized. Finally, strategies for facilitating same-day direct admission to hospice from the ED are discussed. This article not only can serve as a point-of-care reference for the ED physician but also can assist outpatient oncologists as well as inpatient hospitalists in coordinating care around the ED visit.

晚期癌症患者每年有400万人次到急诊科(EDs)和其他专门的、高灵敏的肿瘤急救中心就诊。由于系统治疗的整体复杂性和老年人群中积极治疗的比例提高，许多经历急性失代偿的患者都很虚弱且急性发病。这篇文章全面回顾了肿瘤急诊的范围和急救中常遇到的急症，讨论了现病史、潜在的病因以及最新的临床路径，强调了安全出院回家或过渡到肿瘤医师团队住院的标准。这篇综述超出了熟悉的情况，如发热性中性粒细胞减少症、高钙血症、肿瘤溶解综合征、恶性脊髓压迫、机械性肠梗阻和突破性疼痛危机，包括更广泛的主题，如抗利尿激素分泌综合征、静脉血栓栓塞、恶性积液以及化疗诱导的粘膜炎、心肌病、恶心、呕吐和腹泻。总结了与靶向治疗，包括小分子、裸抗体和药物偶联单克隆抗体、免疫检查点抑制剂和嵌合抗原受体T细胞治疗相关的紧急并发症。最后，对促进当日直接从急诊科住院的策略进行了讨论。这篇文章不仅可以作为急诊医生的诊疗参考，也可以帮助门诊肿瘤医生和住院医生在急诊前后协调诊疗。