Abstract：
CONTEXT:Patients with metastatic non-small cell lung cancer (NSCLC) have limited survival. Population studies have evaluated the impact of radiation refusal in the curative setting; however, no data exist concerning the prognostic impact of radiation refusal in the palliative care setting. OBJECTIVES:To investigate the patterns of radiation refusal in newly diagnosed patients with metastatic NSCLC. METHODS:Patients with Stage IV NSCLC diagnosed between 1988 and 2010 were identified in the Surveillance, Epidemiology, and End Results database. Univariate and multivariate analyses were used to identify predictors for refusal of radiation and the impact of radiation and refusal on survival in the palliative setting. RESULTS:A total of 285,641 patients were initially included in the analysis. Palliative radiation was recommended in 42% and refused by 3.1% of patients. Refusal rates remained consistent across included years of study. On multivariate analysis, older, nonblack/nonwhite, unmarried females were more likely to refuse radiation (P < 0.001 in all cases). Median survival for patients refusing radiation was three months vs. five months for those receiving radiation and two months for those whom radiation was not recommended. CONCLUSION:Patients with metastatic NSCLC who refuse recommended palliative radiation have a poor survival. Radiation refusal or the recommendation against treatment can serve as a trigger for integrating palliative care services sooner and contributes greatly to prognostic awareness. Further investigation into this survival difference and the factors behind refusal are warranted.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Stavas MJ,Arneson KO,Ning MS,Attia AA,Phillips SE,Perkins SM,Shinohara ETdoi
10.1016/j.jpainsymman.2014.11.298subject
Has Abstractpub_date
2015-06-01 00:00:00pages
1081-1087.e4issue
6eissn
0885-3924issn
1873-6513pii
S0885-3924(15)00032-9journal_volume
49pub_type
杂志文章abstract：CONTEXT:Palliative sedation is used to relieve end-of-life refractory symptoms. OBJECTIVE:The objective of this study was to describe the use of palliative sedation in patients who die in internal medicine departments. METHODS:An observational, cross-sectional, retrospective, and multicenter clinical audit study was ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.10.013
更新日期：2020-02-01 00:00:00
abstract：:Patients with advanced cancer often do not receive high-quality pain and symptom management or support with coordination of care, communication, and decision making. Implementing quality indicators that are reflective of the scope of care, feasible to implement, and supported by evidence might help to identify areas a...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2009.04.024
更新日期：2009-12-01 00:00:00
abstract：CONTEXT:The successful management of breakthrough pain depends on a combination of adequate assessment, appropriate (individualized) treatment, and adequate re-assessment. Currently, there is no fully validated clinical assessment tool for breakthrough pain in cancer patients. OBJECTIVES:The aim of this project was to...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2013.10.026
更新日期：2014-10-01 00:00:00
abstract：CONTEXT:Promoting patient value-concordant end-of-life care is a priority in health care systems but has rarely been examined in randomized clinical trials. OBJECTIVES:To examine the effectiveness of an advance care planning intervention in facilitating concordance between cancer patients' preferred and received life-...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpainsymman.2019.04.010
更新日期：2019-07-01 00:00:00
abstract：:Celiac plexus blockade with ethanol is a widely accepted modality of pain control for adults with cancer pain. The role of interventional strategies in children is less well established. A 7-year-old child with abdominal pain secondary to a Wilms tumor was treated with neurolytic celiac plexus blockade. This resulted ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/0885-3924(95)00014-P
更新日期：1995-05-01 00:00:00
abstract：:Indwelling subcutaneous cannula for the administration of intermittent morphine boluses postoperatively have been used in several centers as an alternative to intramuscular (IM) injections. We introduced this technique to our hospital, assessed it for complications in 220 children, and conducted a survey to see if nur...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(96)00200-x
更新日期：1997-01-01 00:00:00
abstract：CONTEXT:The 3-Act Model is an innovative narrative approach to goals of care (GOC) discussions centered on patients' unique stories. Previous studies have demonstrated the effectiveness of the 3-Act Model training in enhancing trainees' skills objectively in role-plays with standardized patients. This study moves beyon...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.06.017
更新日期：2020-10-01 00:00:00
abstract：CONTEXT:Oncology patients with persistent pain treated in outpatient settings and their family caregivers have significant responsibility for managing pain medications. However, little is known about their practical day-to-day experiences with pain medication management. OBJECTIVES:The aim was to describe day-to-day p...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpainsymman.2013.12.242
更新日期：2014-11-01 00:00:00
abstract：:Infection is common among advanced cancer patients. This study was undertaken to review the pattern of use of antibiotics and to identify potential factors that could affect outcomes after infection. The medical records of all patients with advanced cancer who were enrolled into the palliative care service of a distri...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2005.06.005
更新日期：2005-12-01 00:00:00
abstract：CONTEXT:Palliative services have historically been offered to terminal patients with cancer, but much less so in other chronic illnesses such as chronic obstructive pulmonary disease (COPD) because of difficulties in predicting the trajectory to death. OBJECTIVES:The goal of this study was to determine if the change o...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：10.1016/j.jpainsymman.2012.10.283
更新日期：2013-10-01 00:00:00
abstract：:Many patients suffer from chronic, intractable neuropathic pain. Despite similar diagnoses and presumed pathophysiologies, symptoms and response to treatment can differ. Monotherapy is only occasionally successful. In this prospective survey, 20 patients with chronic, neuropathic pain not responding to interventional ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(00)00131-7
更新日期：2000-05-01 00:00:00
abstract：:There is little objective data on how cancer and its therapy affect physical activity. The main aims of this pilot study were 1) to compare physical activity in patients receiving palliative chemotherapy and healthy controls, and 2) to explore the relationship between patients' activity, quality of life (QoL), and cli...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2006.09.024
更新日期：2007-06-01 00:00:00
abstract：:Pain was measured and analgesic treatment examined in 131 children and adolescents, 8-17 years of age, for 5 days after surgery. Analgesic data were converted to 10 mg intramuscular morphine-equivalent doses (IMMSEQ) and were designated appropriate or inappropriate for body weight. Analgesic onset, peak, and duration ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/0885-3924(94)90161-9
更新日期：1994-02-01 00:00:00
abstract：:We explored the effect of intravenous infusions of a bisphosphonate, pamidronate, in the management of chronic mechanical spinal pain, a worldwide public health problem in terms of lost workdays, medical treatment costs, and suffering. Bisphosphonates have an anti-nociceptive effect in animals. In humans, intravenous ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(03)00201-x
更新日期：2003-07-01 00:00:00
abstract：CONTEXT:Palliative care research in Africa is in its relative infancy, with dedicated financial support extremely limited. Therefore, setting research priorities to optimize use of limited resources is imperative. OBJECTIVES:To develop a prioritized research agenda for palliative care in Africa. METHODS:We used a two...
journal_title：Journal of pain and symptom management
pub_type： 共识发展会议,杂志文章
doi：10.1016/j.jpainsymman.2013.03.022
更新日期：2014-02-01 00:00:00
abstract：:The use of cardiac pacemakers and arrhythmia control devices is increasingly common. The presence of a previously placed pacemaker or implantable cardioverter-defibrillator (ICD) in a terminally ill patient may result in medical and ethical issues for the patient, family, and healthcare provider. Two cases are present...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(99)00038-x
更新日期：1999-08-01 00:00:00
abstract：:The rectal route for the administration of opioid analgesics is often forgotten by physicians seeking alternatives to the oral route. This article reviews the physiology of rectal drug absorption and such data as exists on the different opioids that have been administered by this route. Conventional fatty-based suppos...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/s0885-3924(05)80025-9
更新日期：1990-04-01 00:00:00
abstract：BACKGROUND:There is currently no universally accepted outcome measure in cancer pain management. The personalized pain goal (PPG) has been shown to be a relevant outcome measure. We examined its use in routine outpatient practice and compared it with the clinically important difference (CID, ≥2 points or 30%), a pain o...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2018.03.004
更新日期：2018-07-01 00:00:00
abstract：CONTEXT:The prevalence of neuropathic pain in patients with cancer pain has been estimated to be around 40%. Neuropathic pain may be caused by tumor invasion and is considered as mixed nociceptive-neuropathic pain, or caused by an anticancer treatment and considered as purely neuropathic pain. The use of adjuvant analg...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpainsymman.2012.10.230
更新日期：2013-10-01 00:00:00
abstract：CONTEXT:Observer-based sedation scales have been used to provide a measurable estimate of the comfort of nonalert patients in palliative sedation. However, their usefulness and appropriateness in this setting has not been demonstrated. OBJECTIVES:To study the reliability and validity of observer-based sedation scales ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2011.11.010
更新日期：2012-11-01 00:00:00
abstract：CONTEXT:Over the history of palliative care provision in Ireland, services have predominantly provided care to those with cancer. Previous estimates of palliative care need focused primarily on specialist palliative care and included only a limited number of nonmalignant diseases. OBJECTIVES:The primary aim of this st...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2014.09.011
更新日期：2015-04-01 00:00:00
abstract：:Initial dose finding in patients with cancer pain who are started on TTS fentanyl (Duragesic, TTS-F) is often unsatisfactory with currently recommended doses and intervals. Acknowledging that studies reveal a "psuedo steady state" 15 to 20 hr after application of TTS-F, we prospectively investigated an increased initi...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0885-3924(95)00162-x
更新日期：1996-03-01 00:00:00
abstract：:To evaluate the role of oral ketamine as an adjuvant to oral morphine in cancer patients experiencing neuropathic pain, 9 cancer patients (5 men, 4 women) taking maximally tolerated doses of either morphine, amitriptyline, sodium valproate, or a combination of these drugs for intractable neuropathic pain, and reportin...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：10.1016/s0885-3924(01)00373-6
更新日期：2002-01-01 00:00:00
abstract：:Palliative care developed unevenly in Edmonton in the 1980s and early 1990s. Health care budget cuts created an opportunity for innovative redesign of palliative care service delivery. This report describes the components that were developed to build an integrated comprehensive palliative care program, the use of comm...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2007.02.012
更新日期：2007-05-01 00:00:00
abstract：:The use of intrathecal diamorphine via an implanted portal system is described for pain control in a patient suffering from vertebral metastatic disease. The complication of myoclonic spasms affecting the lower half of the body occurred after 14 days, when increasing the bolus dose to 40 mg. The spasms lasted for 3 hr...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/0885-3924(93)90192-x
更新日期：1993-10-01 00:00:00
abstract：:Over the last few years, Nepali and international colleagues have been collaborating in the development of palliative care services in Nepal. The program continues to move forward amid the considerable social and political difficulties facing Nepal. Although a number of individuals and organizations have been involved...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2007.02.009
更新日期：2007-05-01 00:00:00
abstract：CONTEXT:Both maintaining hope and preparing for the patient's death are important for families of terminally ill cancer patients. OBJECTIVES:The primary aim of this study was to clarify the level of the family's achievement of maintaining hope and preparing for death and the professional's behavior related to their ev...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2012.05.014
更新日期：2013-05-01 00:00:00
abstract：CONTEXT:Systematic reviews and meta-analyses suggest that community specialist palliative care services (SPCSs) can avoid hospitalizations and enable home deaths. But more information is needed regarding the relative efficacies of different models. Family caregivers highlight home nursing as the most important service,...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpainsymman.2012.02.017
更新日期：2013-02-01 00:00:00
abstract：CONTEXT:Lack of knowledge or misconceptions about palliative care (PC) can serve as barriers to accessing PC for seriously ill patients. Although self-reported rates of PC knowledge have been increasing, little is known about how self-reports relate to actual PC knowledge. OBJECTIVE:To determine the prevalence of PC k...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.05.008
更新日期：2019-09-01 00:00:00
abstract：:PC-FACS(FastArticleCriticalSummaries for Clinicians inPalliativeCare) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PC-FACS, please encourage them to join ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2017.11.002
更新日期：2018-01-01 00:00:00
