• 제목/요약/키워드: Palliative therapy

검색결과 210건 처리시간 0.024초

말기 대장암환자에서 중상을 통한 예후 측정 및 증상조절 (Predicting Life Span for Terminal Colon Cancer using Clinical Symptoms)

  • 이도행;최윤선;홍명호;김준석;이경진;김영수
    • Journal of Hospice and Palliative Care
    • /
    • 제2권2호
    • /
    • pp.138-143
    • /
    • 1999
  • Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

  • PDF

불완전 방사선치료 환자의 분석 (Why Do Patients Drop Out During Radiation Therapy? - Analyses of Incompletely Treated Patients -)

  • 허승재;우홍균;안용찬;김대용;신경환;이규찬;정원아;김현주
    • Radiation Oncology Journal
    • /
    • 제16권3호
    • /
    • pp.347-350
    • /
    • 1998
  • 목적 : 본 연구는 계획된 방사선치료의 과정 도중에 방사선치료를 완료하지 못하는 환자들의 빈도를 조사하고 그 이유를 분석하고자 하였다. 대상 및 방법 :삼성서울병원 치료방사선과에서 방사선치료를 받은 환자 중에서 1996년 4월부터 1997년 5월까지 방사선치료를 시행 받은 1,100명의 환자들을 대상으로 하였다. 대상 환자들 중에서 최초 계획 방사선량의 95$\%$ 이하를 받은 경우를 불완전 방사선치료로 정의하여 그 빈도와 이유를 조사하였다. 결과 : 불완전 방사선치료의 빈도는 1,100명 중 128명으로 12$\%$였다. 불완전 방사선치료 환자들의 운동수행능력은 전체 환자들에 비하여 불량하였으며, 방사선치료의 목적은 고식적 목적이 많았다. 불완전 방사선치료의 가장 흔한 이유는 환자의 거부였으며 이는 주로 환자의 방사선치료에 대한 불신과 경제적 부담 때문이었다. 결론 : 불완전 방사선치료의 빈도를 줄이기 위해서는 방사선치료의 임상적 적응 여부는 물론 환자의 사회 경제적인 여건을 잘 고려하여 방사선치료의 대상 환자를 선정하는 것이 요망되며 이는 특히 고식적 방사선치료의 경우에 더욱 중요하다고 할 수 있겠다.

  • PDF

Comparing palliative treatment options for cholangiocarcinoma: photodynamic therapy vs. radiofrequency ablation

  • Tayyaba Mohammad;Michel Kahaleh
    • Clinical Endoscopy
    • /
    • 제55권3호
    • /
    • pp.347-354
    • /
    • 2022
  • Referral to an endoscopist is often done once curative resection is no longer an option for cholangiocarcinoma management. In such cases, palliation has become the main objective of the treatment. Photodynamic therapy and radiofrequency ablation can be performed to achieve palliation, with both procedures associated with improved stent patency and survival. Despite the greatly increased cost and association with photosensitivity, photodynamic therapy allows transmission to the entire biliary tree. In contrast, radiofrequency ablation is cheaper and faster to apply, but requires intraductal contact. This paper reviews both modalities and compares their efficacy and safety for bile duct cancer palliation.

말기암환자에서 불응성 호흡곤란 완화를 위한 Furosemide 흡입치료 -대한가정의학회 완화의학연구회 세미나에 기초한- (Applying Inhaled Furosemide for Refractory Breathlessness in Terminally-ill Cancer Patients - Based on Seminar of Palliative Medicine Research Group, The Korean Academy of Family Medicine -)

  • 황인철;이민규;김경곤;이경식;서희선;대한가정의학회 완화의학연구회
    • Journal of Hospice and Palliative Care
    • /
    • 제13권4호
    • /
    • pp.252-256
    • /
    • 2010
  • 말기 암환자에서의 호흡곤란은 매우 흔하면서도 고통스러운 증상이다. 불응성 호흡곤란은 호흡곤란을 야기시키는 가역적인 원인들이 배제되고 기존의 고식적인 치료에 반응하지 않는 상태로 정의할 수 있으며, 일반적으로 아편유사제와 벤조디아제핀이 사용된다. 대한 가정의학회 완화의학연구회에서는 호흡곤란의 원인이 다른 2명의 증례에서 사용한 furosemide 흡입치료에 대해 논의하였다. Furosemide 흡입치료는 비교적 최근에 대두된 것으로 아직까지 그 효과나 기전이 불명확하여 임상에서 일률적으로 사용하기에는 무리가 있지만, 뚜렷한 폐쇄성 기도병변이 없는 불응성 호흡곤란 환자에서는 고려해 볼 수 있겠다. 본 증례토론을 통해 국내 완화의료 종사자들과 furosemide 흡입치료 경험을 공유하고, 아울러 향후 이 주제에 대한 연구의 방향을 제시하고자 한다.

폐암의 방사선치료 결과에 대한 간이보고 (Preliminary Report of the Lung Cancer)

  • 반성범;최명선
    • Radiation Oncology Journal
    • /
    • 제2권1호
    • /
    • pp.81-86
    • /
    • 1984
  • The preliminary analysis has been made of 63 Patients who were treated in the Department of Radiation Therapy at Korea University Hospital for the lung cancer from April 1981 to December 1983. The patients were treated via Co-60 teletherapy unit and the doses were 5,400 rad/ 6 week for the curative, $3,600\~4,500\;rad/2\;1/2\;\~3$ week for the Palliative treatment. Thirty two $(32/63=51\%)$ patients have been for curative, $25/63 (40\%)$ were for Palliative, and $6/63 (9\%)$ were for post-operative radiation. A post-radiation treatment, $28/63 (53\%)$ were able to follow from 2 months to 3 yrs. During the follow up, chest X-rays and/or CT scans were taken and $22/27 (81.4\%)$ of patients were responded more than $50\%$ of tumor regression one month following completion of radiation.

  • PDF

Celestin Tube 를 이용한 진행된 식도암환자에서의 고식적 수술치료 - 6례보고- (Palliative Intubation in Advanced Esophageal Cancer [including esophagorespiratory fistulas] Using Celestin Tube - Report of 6 Cases -)

  • 한재진;조재일;심영목
    • Journal of Chest Surgery
    • /
    • 제22권2호
    • /
    • pp.315-320
    • /
    • 1989
  • Dysphagia is common symptom in patients with advanced esophageal cancer, which is not to be resected surgically. Especially when esophagorespiratory fistula is complicated, it leads to rapid deterioration and death due to pulmonary infection. Esophageal intubation relieves dysphagia as simple surgical execution and offers rapid effectiveness. For six patients with inoperable esophageal cancer including three esophago-respiratory fistulas, the palliative esophageal intubation was performed in Korea Cancer Center Hospital, in 1988. Traction technique via high gastrotomy with Celestin tube was used. Adequate palliation of dysphagia was achieved in 5 patients, but wound infection was developed in 2 patients, tube migration in 2 patients, and 2 died in hospital due to sepsis on the 16th and 42nd postoperative day, respectively. In 3 patients with esophagorespiratory fistula complicated after radiation therapy, the intubation was performed urgently and the result was satisfactory in 2 of them that the fistula was occluded successfully and aspiration or pulmonary infection was prevented.

  • PDF

대장암의 항암 치료 - 언제, 어떻게? (Chemotherapy for Patients with Colorectal Cancer - When and How?)

  • 김재현
    • Journal of Digestive Cancer Research
    • /
    • 제7권1호
    • /
    • pp.1-4
    • /
    • 2019
  • It is important to choose the appropriate treatment option for patients with colorectal cancer (CRC), because it could affect the prognosis of patients. Chemotherapy is effective in prolonging survival and time to progression in patients with advanced CRC. Adjuvant chemotherapy have been reported to reduce the recurrence rate of colorectal cancer by 30% in patients with stage 3 or high risk of stage 2 CRC. Although palliative chemotherapy does not offer long-term benefits, as life expectancy remains below 12 months in most of those receiving treatment, recent developments in the treatment including target agents and immunotherapy have improved the median overall survival time in patients with metastatic CRC by up to 30 months. Chemotherapy for patients with CRC is classified into neoadjuvant, adjuvant, and palliative therapy according to the status of patients. In this review, I summarized the chemotherapy for patients with CRC, which applying in clinical practice.

Palliative Treatment of Advanced Cervical Cancer with Radiotherapy and Thai Herbal Medicine as Supportive Remedy - Analysis of Survival

  • Pesee, Montien;Kirdpon, Wichit;Puapairoj, Anucha;Kirdpon, Sukachart;Prathnadi, Pongsiri
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권3호
    • /
    • pp.1593-1596
    • /
    • 2013
  • Background: To evaluate outcomes using a Thai herbal medicine, Vilac Plus (G716/45) with standard radiotherapy in comparison with historic controls from literature reports of the results of treatment in stage IIIB cervical cancer. Materials and Methods: Between March 2003 and June 2005, thirty patients with advanced cervical cancer stage IIIB-IV who had a poor performance status were treated by palliative radiotherapy along with an adjuvant daily dose of 15-30 ml of Thai herbal tonic solution (Vilac Plus G716/45) administered orally three times after meals as an additional supportive therapy. The results were analyzed from the aspect of the overall survival rates with curves estimated by the Kaplan-Meier method. Results:.The median follow -up time for stage IIIB was 4.2 years with a range of 7.9 months - 6.1 years. The overall 1, 3, and 5 year survival rates for stage IIIB were 88%, 60% and 52%. Conclusions: The overall 5 year survival rate for stage IIIB with a poor performance status was 52% when compared with 34-54.8% for historic controls. The combined complementary palliative radiotherapy (CCPR) had low rates of radiation morbidity. It was a simple technique and feasible for developing countries. The pilot study was limited by the small number of patients and further research will be necessary to assess interrelated and confounding factors in treatment of cervical cancer patients.

병동형 호스피스 환자를 위한 원예요법의 개발 및 수면의 질과 면역기능에 미치는 효과 (Development and Effects of Horticulture Therapy on Quality of Sleep and Immune Function in Patients in Hospice Units)

  • 김정남;송미옥;권윤희
    • 임상간호연구
    • /
    • 제16권3호
    • /
    • pp.39-50
    • /
    • 2010
  • Purpose: The study was done to examine the development and effects of horticulture therapy on quality of sleep and immune function in patients in hospice units. Methods: The participants in this study were hospice patients in D hospital in D city. Thirty hospice patients were assigned to the experimental group, thirty to the control group. Data were collected from April 29 to July 26, 2009. The horticulture therapy program consisted of indoor and outdoor horticultural activities. The horticulture therapy was conducted for 30 minutes, 6 times a week for 3 weeks (a total 18 times). Measures were quality of sleep, and immune function by serum T-cell, NK-cell count. Data were analyzed using descriptive statistics, chi-square test and t-test with SPSS/WIN 13.0 version. Results: Patients in the experimental group receiving horticulture therapy had a significant difference in changes in the quality of sleep compared to the control group. There were also a significant difference in changes in the immune function (serum T cell and serum NK cell) between the experimental group and control group. Conclusion: The study results indicate that horticulture therapy developed for hospice patients is an effective, palliative intervention program to improve the quality of sleep and immune function of hospice patients.

말기 환자의 존엄요법 개념분석 (Dignity Therapy for End-stage Patients: Concept Analysis)

  • 정복례;오은희
    • Journal of Hospice and Palliative Care
    • /
    • 제19권3호
    • /
    • pp.211-221
    • /
    • 2016
  • 목적: 본 연구의 목적은 말기 환자에게 이루어지는 존엄요법의 의미와 속성을 파악함으로써 말기 환자 간호의 질적인 향상에 기여할 수 있도록 하기 위함이다. 방법: 개념의 모든 사용을 확인하기 위하여 2014년 8월에서 2014년 12월까지 한국교육학술정보원(http://www.riss.net), 학술연구정보서비스(http://kiss.kstudy.com), 디비피아(http://www.dbpia.co.kr)에서 '존엄', '존엄요법'을 검색어로 국내문헌을 검색하였고, 국외 문헌의 경우 PubMed와 National Digital Science Links (NDSL)에서 'dignity', 'dignity therapy'를 검색어로 문헌을 검색하였다. 총 51개의 문헌을 Walker와 Avant(2005)의 개념분석 방법을 적용하여 분석하였다. 결과: 존엄요법의 선행요인은 말기 환자, 다양한 고통과 괴로움, 존엄한 죽음에 대한 바램이었다. 속성으로는 삶과 죽음의 질 향상, 치료적 대화, 인간의 존엄과 가치존중, 삶과 죽음에 대한 생각 표현, 체계적 과정으로 나타났고, 결과는 자신의 삶에 대한 반추 기회, 고통과 괴로움 감소, 가치와 존엄감 상승, 자신의 삶에 대한 가족과의 공유, 삶과 죽음의 질 향상, 환자와 가족에게 편안함 제공으로 나타났다. 결론: 존엄요법은 삶의 마지막을 경험하는 환자들이 좀 더 편안함을 느낄 수 있게 해 준다. 따라서 호스피스환자 간호 시 그들의 삶과 죽음의 질을 향상시키기 위해 존엄요법의 속성을 활용할 수 있을 것이다.