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姑息治疗在口腔鳞状细胞癌管理中的整合

Integration of palliative care in the management of oral squamous cell carcinoma.

作者信息

Sridhar Republica, Etimad Huwait, Pushparaj Peter Natesan, Kalamegam Gauthaman

机构信息

RMD Specialities Hospital and RMD Academy for Health, A Unit of RMD Pain and Palliative Care Trust, Chennai, India.

King Abdulaziz Univ, Fac Sci, Dept Biochem, Jeddah 21589, Saudi Arabia.

出版信息

Bioinformation. 2023 Jan 31;19(1):1-4. doi: 10.6026/97320630019001. eCollection 2023.

Abstract

Oral Squamous cell Cancers (OSCC) is strongly associated with tobacco consumption. We here in present a case study of a OSCC patient who refused standard oncological care (SOC), to highlight the importance of integrating palliative care (PC) for improved patient outcomes. A 61 years male patient, with history of chewing tobacco for more than 20 years and diagnosed to have OSCC for 1.5 years presented with severe anaemia and a cauliflower-like growth (12 x 10 cm) in the left oral cavity and cheek with greenish-yellow discharge. Pus culture was positive for and . Patient is also a known hypertensive for 15 years and a diabetic for 7 years on allopathic treatment. However, the patient refused SOC for oral cancer and relied on siddha treatment. Packed cell transfusions were given to correct anaemia and the blood glucose levels was kept under control. Frequent wound debridement, oral care, antibiotics, balanced-diet and hydration improved wound-bed granulation. Patient and family members were counselled and explained in detail on the need for SOC by sharing previous OSCC patients' care and outcomes at our centre. Patient gained trust and courage and agreed for chemotherapy, which reduced the disease burden and improved the quality of life (QoL) considerably. Therefore, PC integration at an early stage of treatment is imperative as it reduced (i) the burden of secondary infection, (ii) pain and distress, and (iii) improved the QoL.

摘要

口腔鳞状细胞癌(OSCC)与烟草消费密切相关。我们在此介绍一例拒绝标准肿瘤治疗(SOC)的OSCC患者的案例研究,以强调整合姑息治疗(PC)对改善患者预后的重要性。一名61岁男性患者,有20多年嚼烟史,被诊断为OSCC 1.5年,出现严重贫血,左口腔和脸颊有菜花状肿物(12×10厘米),伴有黄绿色分泌物。脓液培养 和 呈阳性。患者还是一名已知的高血压患者,患病15年,糖尿病患者,接受西医治疗7年。然而,该患者拒绝接受口腔癌的SOC治疗,依靠悉达治疗。给予浓缩红细胞输血以纠正贫血,并将血糖水平控制在正常范围内。频繁的伤口清创、口腔护理、抗生素、均衡饮食和补液改善了伤口床的肉芽组织。通过分享我们中心之前OSCC患者的护理情况和预后,对患者及其家属进行了咨询,并详细解释了接受SOC治疗的必要性。患者获得了信任和勇气,同意接受化疗,这大大减轻了疾病负担,提高了生活质量(QoL)。因此,在治疗早期整合PC至关重要,因为它减少了(i)继发感染的负担,(ii)疼痛和痛苦,以及(iii)提高了QoL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5424/10504499/3a2623f0b073/97320630019001F1.jpg

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