Lal Punita, Verma Mranalini, Kumar Gaurav, Shrivastava Resham, Kumar Shaleen
Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Indian J Palliat Care. 2016 Oct-Dec;22(4):477-484. doi: 10.4103/0973-1075.191854.
Poor socioeconomic status and illiteracy attribute to the advanced presentation of head and neck cancer (HNC) patients in India and are candidates for palliation in our setup. We set up a palliative cancer care clinic (PCCC), and an audit of initial 153 HNC patients is presented.
To assess the impact of palliative cancer care services.
Data of advanced HNC patients suited for palliation were collected to document demography, symptomatology, cancer treatment, and supportive care.
One hundred and fifty-three patients were seen during January 2013 to March 2015 in the PCCC. Seventy-two (47%) referral cases were due to disease progression and 81 (53%) due to de novo advanced cases. Median follow-up for this group was 5.3 months. Ninety (59%) cases needed some degree of assistance for their normal activities. Sixty-seven (44%) patients belonged to poor socioeconomic status and 65 (43%) were educated up to equivalent of high school. One hundred and thirty-five (88%) patients had an adequate family support. Pain was the most common presenting symptom in 134 (87%) cases with adequate relief in 112 (84%) patients with another 13 (09%) could not be assessed. Overall median duration of symptoms was 6 months. Cancer-directed therapy was used in 143 (93%) patients. Near the end of life in 47 (73%) out of 63 documented cases, caregivers were psychologically prepared for the inevitable.
The role of palliative care team in alleviating physical, psychosocial, and emotional issues of patient and family members was significant. PCCC seems to be a feasible working model in our setup.
社会经济地位低下和文盲现象导致印度头颈癌(HNC)患者就诊时病情已发展到晚期,在我们的机构中这些患者适合接受姑息治疗。我们设立了一个姑息性癌症护理诊所(PCCC),并对最初的153例HNC患者进行了审计。
评估姑息性癌症护理服务的影响。
收集适合姑息治疗的晚期HNC患者的数据,以记录人口统计学、症状、癌症治疗和支持性护理情况。
2013年1月至2015年3月期间,PCCC共接待了153例患者。72例(47%)为转诊病例,原因是疾病进展;81例(53%)为新发晚期病例。该组患者的中位随访时间为5.3个月。90例(59%)患者在正常活动方面需要某种程度的帮助。67例(44%)患者社会经济地位低下,65例(43%)患者受教育程度相当于高中。135例(88%)患者有足够的家庭支持。疼痛是134例(87%)患者最常见的症状,112例(84%)患者疼痛得到充分缓解,另有13例(09%)无法评估。症状的总体中位持续时间为6个月。143例(93%)患者接受了针对癌症的治疗。在63例有记录的病例中,接近生命末期时,47例(73%)的护理人员对不可避免的情况在心理上有所准备。
姑息治疗团队在缓解患者及其家庭成员的身体、心理社会和情感问题方面发挥了重要作用。PCCC在我们的机构中似乎是一个可行的工作模式。