Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Cases and Literature Review of Timing for Withdrawal of Palliative Chemotherapy

진행성 암환자에서 완화적 항암치료 중단 시점의 결정에 대한 증례보고와 문헌고찰

  • Jeong, Yun Jin (Division of Hematology and Medical Oncology, Department of Internal Medicine, Ilsan Hospital, Dongguk University College of Medicine) ;
  • Kim, Do Yeun (Division of Hematology and Medical Oncology, Department of Internal Medicine, Ilsan Hospital, Dongguk University College of Medicine)
  • 정윤진 (동국대학교 일산병원 내과학교실) ;
  • 김도연 (동국대학교 일산병원 내과학교실)
  • Received : 2015.10.08
  • Accepted : 2015.12.28
  • Published : 2016.03.01
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Abstract

Advanced incurable cancer patients receive palliative chemotherapy to prolong their life and improve quality of life. However, physicians should assess the timing to discontinue the treatment, especially near the final months of life, as palliative chemotherapy may accompany considerable toxicity. Even though there are no clear guidelines regarding the withdrawal timing for anticancer treatment in palliative setting, it is important clarify the issue for quality of care for advanced cancer patients. Here, we present two patients who received palliative chemotherapy for advanced colon cancer and non-small cell lung cancer, respectively. In both cases, it was jointly determined to stop palliative chemotherapy, and best efforts are made to relieve troublesome symptoms. The cases and up-to-date literature review will highlight the importance of the timing of discontinuation of cancer treatments when changes are being made to the health care system and hospice and palliative medicine is taking root in Korea.

완치가 불가능한 진행성 암환자에게 시행되는 완화적 항암치료의 목표는 생명연장과 삶의 질 향상이다. 그러나 완화적 항암치료는 상당한 독성을 가질 수도 있기 때문에 의사는 항암제 투여의 중단시점에 대해, 특히 생의 마지막 몇 달 내 기간에는, 항상 지속적으로 평가해야 한다. 완화적 항암치료를 중단하는 분명한 권고안은 없지만 진행성 암환자 돌봄의 질 향상을 위해 해결해야 할 쟁점이다. 저자는 완화적 항암치료를 투여 받았던 진행성 대장암, 비소세포 폐암 환자 두 증례를 기술하였다. 두 증례 모두 완화적 항암치료의 중단에 대한 공동 결정 하에 현재까지 최대한의 증상 치료를 시행하고 있다. 두 증례와 최근까지의 문헌고찰을 통해 국내 호스피스 완화의료가 확립 되어가는 시점에서, 항암치료의 중단 시점과 결정에 대해 부각시키는 바이다.

Keywords

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