• Title/Summary/Keyword: Palliative therapy

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Surgical Outcomes and Survival Prognostic Factors for Palliative Gastrectomies in Stage IV Resectable Gastric Cancer Outlet Obstruction Patients

  • Choi, Won Yong;Kim, Hyun Il;Park, Seong Ho;Yeom, Jong Hoon;Jeon, Woo Jae;Kim, Min Gyu
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.421-430
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    • 2020
  • Purpose: Currently, there is no clear evidence to support any specific treatment as a principal therapy for stage IV gastric cancer outlet obstruction (GCOO) patients. This study evaluated the outcomes of palliative gastrectomies and survival prognostic factors in patients with stage IV resectable GCOO. Materials and Methods: We retrospectively reviewed the medical records of 48 stage IV GCOO patients who underwent palliative gastrectomies between June 2010 and December 2019. Palliative gastrectomies were performed only in patients with resectable disease. Early surgical outcomes and prognostic factors were analyzed using univariate and multivariate analyses. Results: There were no specific risk factors for postoperative complications, except for being underweight. Severe postoperative complications developed in five patients, and most of the patients underwent interventional procedures and received broad-spectrum antibiotics for intra-abdominal abscesses. The multivariate survival analysis showed that palliative chemotherapy is a positive prognostic factor, while the specific type of hematogenous and lymphatic metastasis is a negative prognostic factor. Conclusions: We recommend that the treatment method for stage IV GCOO should be selected according to each patient's physical condition and tumor characteristics. In addition, we suggest that palliative gastrectomies can be performed in stage IV resectable GCOO patients without unfavorable prognostic factors (types of hematogenous and lymphatic metastases).

The Radiopharmaceutical Therapy for Multiple Bone Metastases of Cancer (암의 다발성 뼈 전이의 방사성동위원소 치료)

  • Choi, Sang Gyu
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.207-215
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    • 2014
  • Multiple bone metastases are common manifestation of many malignant tumors such as lung cancer, breast cancer, prostate cancer and renal cell carcinoma. Bone metastasis is secondary cancer in the bone, and it can lead to bone pain, fracture, and instability of the weight bearing bones, all of which may profoundly reduce physical activity and life quality. Treatment for bone metastasis is determined by multiple factors including pathology, performance status, involved site, and neurologic status. Treatment strategies for bone metastasis are analgesics, surgery, chemotherapy and radiotherapy. External beam radiotherapy has traditionally been an effective palliative treatment for localized painful bone metastasis. However, in some cases such as multiple bone metastases, especially osteoblastic bone metastasis originated from breast or prostate cancer, the radiopharmaceutical therapy using $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ are also useful treatment option because of administrative simplicity (injection), few side effects, low risk of radiation exposure and high response rate. This article offers a concise explanation of the radiopharmaceutical therapy for multiple bone metastases.

Bedside Teaching of Relaxation Technique for Terminal Cancer Patients Treated with Radiation Therapy (방사선치료를 받는 말기암환자들을 대상으로 한 이완요법)

  • Kim, Sang-Won;Chun, Mison;Kim, Hyo Shin
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.256-261
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    • 2016
  • Radiation therapy is an effective modality to alleviate cancer-related symptoms. To deliver radiation accurately, it is essential to secure stability of the treatment position in patients during each treatment time. However, some patients could be less cooperative due to their psychoemotional issues. We present two cases of terminal-stage cancer patients who were initially unable to lie still on the treatment table before simulation. A relaxation technique was taught to them on the bed, and they could relax and undergo radiation therapy with effective symptom relief.

Radiologic Evaluation for Resectability of Pancreatic Adenocarcinoma (췌장 선암의 절제 가능성 평가)

  • Shin Hye Hwang;Mi-Suk Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.315-334
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    • 2021
  • Imaging studies play an important role in the detection, diagnosis, assessment of resectability, staging, and determination of patient-tailored treatment options for pancreatic adenocarcinoma. Recently, for patients diagnosed with borderline resectable or locally advanced pancreatic cancers, it is recommended to consider curative-intent surgery following neoadjuvant or palliative therapy, if possible. This review covers how to interpret imaging tests and what to consider when assessing resectability, diagnosing distant metastasis, and re-assessing the resectability of pancreatic cancer after neoadjuvant or palliative therapy.

Outcome of Palliative and Radical Radiotherapy in Patients with Oral Squamous Cell Carcinoma - a Retrospective Study

  • Rai, Narendra Prakash;Divakar, Darshan Devang;Al Kheraif, Abdulaziz Abdullah;Ramakrishnaiah, Ravikumar;Mustafa, Shabil Mohamed;Durgesh, BH;Basavarajappa, Santhosh;Khan, Aftab Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6919-6922
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    • 2015
  • Background: The treatment selection for the oral squamous cell carcinoma remains controversial. Radiation therapy or surgical excision of the lesion can be applied as the sole treatment or it can be used in combination with other treatment modalities. Radiotherapy is considered to be the safest of all the treatment modalities and can be used in several situations for oral and oropharyngeal cancers. The aim of this study was to evaluate the survival outcome differences in patients treated with radical and palliative radiotherapy as the primary treatment modality. Materials and Methods: The study included a total of 47 patients with oral cancer reporting to our hospital between years 2009 to 2010. The age group for the selected patients was more than 65 years, treated with radical and palliative radiotherapy with no prior surgical interventions. Patients were evaluated till Dec 2013 for overall survival time. Results: Twenty nine patients were treated with radical radiotherapy as main stay of treatment, out of which 21 died during the follow up time with median survival of $352{\pm}281.7$ days with 8 patients alive. All the 16 patients were dead who received palliative radiotherapy with a median survival time of $112{\pm}144.0$ days. Conclusions: This retrospective study showed improved overall survival time, loco regional control rates and reduced morbidity in patients treated with radical radiotherapy when compared to patients treated with palliative radiotherapy.

Hospice and Palliative Care in Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환의 호스피스 완화의료)

  • Shin, Jinyoung;Park, Hye Yun;Lee, Jungkwon
    • Journal of Hospice and Palliative Care
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    • v.20 no.2
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    • pp.81-92
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

The Current Status Regarding the Use of Music for Bereavement Care and the Program Coordinators' Perception in Hospice and Palliative Settings in South Korea (국내 호스피스·완화의료 기관 내 사별돌봄을 위한 음악 활용 현황 및 프로그램 코디네이터의 인식)

  • Kim, Jisoo;Lee, Jin Hyung
    • The Journal of the Korea Contents Association
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    • v.18 no.11
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    • pp.258-266
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    • 2018
  • The purpose of this study was to investigate the current status and the perception of hospice and palliative care program coordinators regarding the use of music in bereavement care in Korea. Both on-line and off-line questionnaires were distributed to program coordinators in 91 institutions, and 54 responses were analyzed by descriptive statistics and Mann-Whitney U test. Even though 92.6% of the participants currently provide a form of bereavement care and 51.9% utilize music as a part of their bereavement program, only 20.3% indicated that their bereavement programs were adequate to address the issues involved, suggesting a need for improvement. As the perceived necessity of bereavement care(4.52) and music therapy based bereavement care(4.20) were generally high, this study supports the need for further development of both forms of bereavement care in Korea.

Palliative Care Provided for Older Patients with Terminal Stage of Cardiopulmonary Disease Before and After Life-Sustaining Treatment Decisions (만성 심폐질환을 가진 말기 노인환자의 연명의료결정 전후 완화간호의 제공)

  • Choi, Jung-Ja;Kim, Su Hyun
    • Journal of Convergence for Information Technology
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    • v.11 no.1
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    • pp.45-53
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    • 2021
  • This study was a retrospective descriptive study to identify frequency and change of palliative care provided for older patients with terminal stage of cardiopulmonary disease before and after life-sustaining treatment (LST) decision making. As a result of chart review of 124 older patients in a university hospital, oral analgesics medication, cold and hot therapy for pain management, antibiotics medication and urine culture for urinary infection, oral care, hair wash, and partial bath were provided significantly less after LST decision making. Provision of praying and relaxation therapy for pain control, oral and nasal care, and emotional care were not changed before and after LST decision making. Spiritual care was the least provided care. Therefore, non-pharmacological pain management, emotional care, and spiritual care need to be improved for older patients with terminal cardiopulmonary disease at the end of life.

Irinotecan as a Palliative Therapy for Metastatic Breast Cancer Patients after Previous Chemotherapy

  • Lan, Hai;Li, Yan;Lin, Cong-Yao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10745-10748
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    • 2015
  • Background: This analysis was conducted to evaluate the efficacy and safety of irinotecan based chemotherapy for treatment of patients with metastatic breast cancer (MBC) who experienced disease progression after one to three chemotherapy regimens, including at least one anthracycline- or taxane-based. Methods: Clinical studies were identified using a predefined search strategy. Pooled response rates (RR) to treatment were calculated. Results: As irinotecan based regimens, 5 clinical studies which including 217 patients with refractory MBC were considered eligible for inclusion, with irinotecan, cisplatin, capecitabine, or TS-1. Systemic analysis suggested that, in all patients, pooled RR was 48.8% (106/217) with irinotecan based regimens. Thrombocytopenia and leukocytopenia were the main side effects. No grade III or IV renal or liver toxicity was observed. No treatment related deaths occurred. Conclusion: This systemic analysis suggests that irinotecan based regimens are beneficial and safe for treating patients with MBC after other chemotherapy.

Piroxicam, Mitoxantrone, and Hypofractionated Radiation Therapy with Volumetric Modulated Arc Therapy for Treating Urinary Transitional Cell Carcinoma in a Dog: A Case Report

  • Hwang, Tae-Sung;An, Soyon;Choi, Moon-Young;Huh, Chan;Song, Joong-Hyun;Jung, Dong-In;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.39 no.1
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    • pp.16-22
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    • 2022
  • A 12-year-old spayed female beagle dog was presented with pollakiuria and stranguria. Abdominal ultrasonography identified irregular a marginated, hyperechoic mass in the urethra and trigon area of the bladder. Computed tomography (CT) revealed a heterogeneous mass in the trigone area leading to a urethra. There was no evidence of regional or distant metastasis. Cytologic analysis suspected transitional cell carcinoma (TCC). The patient was treated with piroxicam, mitoxantrone, and once weekly fractionated radiation therapy (RT) with volumetric modulated arc therapy (VMAT). A follow-up CT scan at 6 months after RT revealed a reduction in tumor size. At 17 months after the start of RT, the patient became severely anorectic and lethargic. Ultrasound examination revealed a hyperechoic mass in the apex area of bladder while the trigone area of the bladder and urethra appeared normal. Multiple hypoechoic nodules of various sizes were found in the liver and spleen. The patient was humanely euthanized at the request of the owner. A combination of piroxicam, mitoxantrone, and hypofractionated RT with VMAT protocol was well tolerated. This case described tumor response and survival time of a canine TCC treated with piroxicam, mitoxantrone, and once weekly palliative RT using computer-assisted planning and VMAT.