NCCN临床实践指南_癌症相关疲劳(2019.V1)英文版

Continue NCCN org Version 1 2019 03 12 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Clinical Practice Guidelines in Oncology NCCN Guidelines Cancer Related Fatigue Version 1 2019 March 12 2019 Continue NCCN Guidelines Index Table of Contents Discussion Version 1 2019 03 12 19 National Comprehensive Cancer Network Inc 2019 All rights reserved The NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Guidelines Version 1 2019 Panel Members Cancer Related Fatigue Ann M Berger PhD APRN Chair Fred 10 Worst fatigue you can imagine or None mild moderate severe Age 7 12 y Severity 1 5 scale 1 Not tired 5 Worst Age 5 6 y Use tired or not tired Age 12 y None to mild 0 3 b Age 7 12 y 1 2 Age 5 6 y Not tired Age 12 y Moderate 4 6 b or Severe 7 10 b Age 7 12 y Moderate 3 or Severe 4 5 Age 5 6 y Tired Education counseling and general strategies for management of fatigued with an emphasis on continued surveillance Education counseling and general strategies for management of fatigued Ongoing evaluation See Primary Evaluation FT 4 NCCN Guidelines Version 1 2019 Cancer Related Fatigue Version 1 2019 03 12 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN Note All recommendations are category 2A unless otherwise indicated Clinical Trials NCCN believes that the best management of any patient with cancer is in a clinical trial Participation in clinical trials is especially encouraged NCCN Guidelines Index Table of Contents Discussion Printed by Maria Chen on 3 12 2019 11 31 50 PM For personal use only Not approved for distribution Copyright 2019 National Comprehensive Cancer Network Inc All Rights Reserved FT 4 PRIMARY EVALUATION FATIGUE SCORE MODERATE OR SEVERE Age 12 y 4 10 Age 7 12 y 3 5 or Age 5 6 y Tired Focused History Disease status and treatment Consider recurrence and or progression Prescription medications OTCs and supplements Medications side effects drug interactions See NCCN Guidelines for Older Adult Oncology OAO H Review of systems In depth fatigue history Onset pattern duration Change over time Associated or alleviating factors Interference with function Social support status availability of caregivers Economic status and resources for obtaining tangible support Assessment of Treatable Contributing Factors Pain Emotional distress Depression Anxiety Anemia Sleep disturbance poor sleep hygiene eg insomnia narcolepsy obstructive sleep apnea restless legs syndrome Nutritional deficits imbalance Vitamin status Weight caloric intake changes Fluid electrolyte imbalance sodium potassium calcium magnesium Decreased functional status Physical activity level Deconditioning Comorbidities Cancer treatment sequelae Alcohol substance abuse Cardiac dysfunction Endocrine dysfunction eg hot flashes hypothyroidism hypogonadism adrenal insufficiency with special concern for people receiving immunotherapy Gastrointestinal dysfunction Hepatic dysfunction Infection Neurologic dysfunction Pulmonary dysfunction Renal dysfunction Management of concurrent symptoms and treatable contributing factors Medications side effects drug interactions Pain See NCCN Guidelines for Adult Cancer Pain Emotional distress See NCCN Guidelines for Distress Management Anemia See NCCN Guidelines for Cancer and Hematopoietic Growth Factors Sleep disturbance poor sleep hygiene See NCCN Guidelines for Survivorship Nutritional deficit imbalance Decreased functional status Comorbidities See NCCN Guidelines for Management of Immunotherapy Related Toxicities See FT 5 for General Strategies for the Management of Fatigue NCCN Guidelines Version 1 2019 Cancer Related Fatigue Version 1 2019 03 12 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN Note All recommendations are category 2A unless otherwise indicated Clinical Trials NCCN believes that the best management of any patient with cancer is in a clinical trial Participation in clinical trials is especially encouraged NCCN Guidelines Index Table of Contents Discussion Printed by Maria Chen on 3 12 2019 11 31 50 PM For personal use only Not approved for distribution Copyright 2019 National Comprehensive Cancer Network Inc All Rights Reserved eSee Discussion for information on differences between active treatment post treatment and end of life treatment See MS 1 fInterventions should be culturally specific and tailored to the needs of patients and families along the illness trajectory because not all patients may be able to integrate these options due to variances in individual circumstances and resources gThere is a lack of s