Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
-
Support Care Cancer · Jun 2007
Artificial nutrition and hydration in terminal cancer patients: the real and the ideal.
To better understand current practice relating to artificial nutrition/hydration in terminal cancer patients, we enrolled terminal cancer patients who were admitted at Seoul National University Boramae Hospital for supportive care only and who died with a duration of hospital stay to death of more than 1 week between 2003 and 2004. We detailed oral intake and intravenous nutrition/hydration status on admission, 1 week after admission, and 2 days before death. Administered calories and changes in these according to time and "DNR" (do-not-resuscitate) status were noted. ⋯ This study showed the high prevalence of artificial nutrition/hydration, especially intravenous infusion, in Korean terminal cancer patients compared with situation in other countries. More studies are needed to verify the efficacy of artificial nutrition/hydration in terminal cancer patients.
-
Support Care Cancer · May 2007
The impact of the palliative care mobile team on symptom assessment and medication profiles in patients admitted to a comprehensive cancer center.
In recent years, tertiary care hospitals and cancer centers have shown great interest in forming palliative care consultation teams. Thus, these centers may be interested in the types of care that such teams give, which could help the other centers put together their own teams. However, the availability of such information is limited. The purpose of our study was therefore to describe the experience of a palliative care team at our comprehensive cancer center. ⋯ Palliative care mobile teams make multiple changes in previous medications and provide almost universal counseling services to patients and families. The length of involvement with the patient and family is short; therefore, rapid stabilization and counseling are required. Our findings regarding medication changes could be helpful to tertiary care hospitals and cancer centers considering palliative care consultation teams.
-
Support Care Cancer · Apr 2007
ReviewReview of patterns of practice and patients' preferences in the treatment of bone metastases with palliative radiotherapy.
Since the 1980s, randomized clinical trials showed that single fraction radiotherapy (RT) provided equal pain relief as multiple fractions of RT in the treatment of bone metastases. ⋯ Despite strong evidence supporting the use of single fraction RT, current practices and preferences favor multiple fractions for the treatment of bone metastases. This has significant implications for the overall quality of life, RT department workload, costs to healthcare systems, and patient convenience.
-
Support Care Cancer · Apr 2007
Randomized Controlled Trial Comparative StudyRandomized, double-blind trial comparing the antiemetic effect of tropisetron plus metopimazine with tropisetron plus placebo in patients receiving multiple cycles of multiple-day cisplatin-based chemotherapy.
To compare the antiemetic efficacy and tolerability of tropisetron plus metopimazine with tropisetron plus placebo during 4 cycles of multiple-day, cisplatin-based chemotherapy. ⋯ Tropisetron plus metopimazine is superior to tropisetron during 4 cycles of multiple-day cisplatin-based chemotherapy, but both treatments are ineffective in a number of patients. The effect of the combination seems comparable to that of ondansetron plus dexamethasone. Newer drugs such as the neurokinin(1) receptor antagonist, aprepitant, should be investigated to optimize antiemetic therapy in patients receiving multiple-day chemotherapy.
-
Neuropathic pain occurs in 1% of the population and is difficult to manage. Responses to single drugs are limited in benefit. Thirty percent will fail to respond altogether. This is a review of newer drugs and treatment paradigms. ⋯ Drug choices are now based not only on efficacy but also toxicity and drug interactions. For this reason, SNRIs and gabapentin/pregabalin have become popular though efficacy is not better than TCAs. Multiple drug therapies becoming an emergent treatment paradigm research in multiple drug therapy are needed.