Abstract:
BACKGROUND:Numerous studies have focused on the treatment of non-small cell lung cancer patients with brain metastases. However, to our knowledge, few have sought to examine outcomes in patients who required whole brain radiation and developed radiation-refractory disease. METHODS:This study examined the medical records of all non-small cell lung cancer patients who developed brain metastases between 2004 and 2013, required whole brain radiation, and received their cancer treatment at the Mayo Clinic in Rochester, Minnesota. RESULTS:A total of 141 patients, most of whom were symptomatic, met the above criteria. Of these, 33 (23%) did not tolerate a corticosteroid taper and were therefore deemed to have radiation-refractory disease. The median survival of patients with and without radiation-refractory disease was 3.12 and 4.27 months, respectively, (hazard ratio [HR]: 0.65 [95% confidence interval (CI): 0.44-0.99]; p=0.04 by log rank test). In a subgroup analysis of patients with radiation-refractory disease (n=33) and radio-responsive disease (n=43), median survival was 3.12 and 5.94 months, respectively (HR: 0.43 [95% CI: 0.26-0.70]). Among patients with radiation-refractory disease, 12 received chemotherapy after radiation, and two received erlotinib. Systemic therapy was associated with improved symptoms in two patients but did not appear to improve survival. CONCLUSION:Non-small cell lung cancer patients with radiation-refractory brain metastases represent a small subgroup who have a short survival and who appear to derive minimal benefit from systemic cancer therapy.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Spiceland CM,Olivier KR,Jatoi Adoi
10.1089/jpm.2015.0097subject
Has Abstractpub_date
2015-08-01 00:00:00pages
707-10issue
8eissn
1096-6218issn
1557-7740journal_volume
18pub_type
杂志文章abstract:BACKGROUND:Prognostic tools are available to predict if terminally ill cancer patients have days or weeks to live. Tools for predicting the prognosis in ambulatory patients at an earlier stage are lacking. The Number of Risk Factors (NRF) score developed in ambulatory cancer patients receiving palliative radiation ther...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0256
更新日期:2014-07-01 00:00:00
abstract:: Background: Dyspnea is common in interstitial lung disease (ILD) patients and often refractory to conventional treatment. Little is known regarding the safety of systemic morphine in ILD patients. Objective: The objective of th...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0272
更新日期:2018-12-01 00:00:00
abstract:: Background: Futile or potentially inappropriate care (futile/PIC) for dying inpatients leads to negative outcomes for patients and clinicians. In the setting of rising end-of-life health care costs and increasing physician burnout, it is important to understand the causes ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0385
更新日期:2019-09-01 00:00:00
abstract:PURPOSE:The majority of dying patients do not have access to necessary drugs to alleviate their most common symptoms, despite evidence of drug efficacy. Our aim was to explore the degree of consensus about appropriate pharmacological treatment for common symptoms in the last days of life for patients with cancer, among...
journal_title:Journal of palliative medicine
pub_type: 共识发展会议,杂志文章
doi:10.1089/jpm.2012.0205
更新日期:2013-01-01 00:00:00
abstract::Purpose of report: Understanding the impact of palliative care interventions on intensive care unit (ICU) costs and utilization is critical for demonstrating the value of palliative care. Performing these economic assessments, however, can be challenging. The purpose of this special report is to highlight and discuss ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0548
更新日期:2017-12-01 00:00:00
abstract::Relief of adverse events induced by chemotherapy is an important issue for patients, especially those with a poor prognosis, such as with pancreatic cancer. There are no reports of the relationship between gastroesophageal reflux disease (GERD) and chemotherapy, so we investigated the incidence of chemotherapy-induced...
journal_title:Journal of palliative medicine
pub_type: 临床试验,杂志文章
doi:10.1089/jpm.2009.0404
更新日期:2010-07-01 00:00:00
abstract:: Background: Palliative care (PC) teams increasingly care for patients with cancer into survivorship. Cancer survivorship transcends distinctions between acute, chronic, malignant, and nonmalignant pain. Partnering with oncologists, PC teams manage pain that persists after ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0171
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Antibiotic administration is frequent in terminal patients with cancer, yet the effects on survival are still under debate. OBJECTIVE:The aim of this study was to examine the status of infection and the benefit/burden of antibiotic administration on the survival of terminal patients with cancer with infecti...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0634
更新日期:2013-11-01 00:00:00
abstract:: Background: Methadone may play a role in the control of refractory cancer pain in opioid switching, although some cases fail to switch to methadone. Objective: To evaluate the differences in the clinical aspects in switching to...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0490
更新日期:2019-07-01 00:00:00
abstract::The emerging role of the advanced practice nurse (APN) as a palliative care provider is gaining increased recognition in the United States. The APN's ability to perform comprehensive physical evaluations, order and interpret diagnostics, and prescribe appropriate medications while receiving reimbursement allow this pr...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662103322515211
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Although most hospice care occurs in the home, a growing number of patients utilize inpatient hospice settings. An inpatient hospice stay requires one or more transitions in care settings, although little is known about these transitions. OBJECTIVE/DESIGN:Using ethnographic methods, this study examined the ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0359
更新日期:2014-04-01 00:00:00
abstract::Many physicians and patients do not discuss care at the end of life and most practicing physicians have had little formal education concerning end-of-life discussions. To address this deficiency, our internal medicine residency faculty participated in the National End of Life Residency Education Project and implemente...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/10966210260499131
更新日期:2002-12-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1089/jpm.2015.0266
更新日期:2016-03-01 00:00:00
abstract:: Objectives: To discuss the outcomes of a formalized care transition process for palliative care patients from the hospital to the community. Background: Patients who received inpatient palliative care services from the speciali...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0090
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Percutaneous stenting is established in the palliation of malignant biliary obstruction. We examined the indications, success rate, complications, and long-term postoperative course of patients undergoing this procedure. METHODS:All patients undergoing percutaneous transhepatic cholangiography (PTC) and m...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0205
更新日期:2010-11-01 00:00:00
abstract:INTRODUCTION:In geriatrics, most risk factors associated with falls have been identified and management strategies developed accordingly. This is not the case in palliative care. The incidence rate of falls, the consequences related to falls, and other related factors were determined in elderly cancer patients hospital...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2007.0241
更新日期:2008-07-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0197
更新日期:2019-02-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.100
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Advanced cancer can erode patients' wellbeing. Narrative interventions have improved patients' wellbeing, but might not be feasible for widespread implementation. OBJECTIVES:(1) Test the effects of miLivingStory, a telephone-based life review and illness narrative intervention with online resources and soci...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2017.0007
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Antiemetics are being used both for the treatment and prophylaxis of opioid-induced nausea and vomiting (OINV) in clinical practice, despite the lack of evidence for the prophylactic benefit. Data regarding the actual status of prophylactic antiemetic use for OINV remain to be elucidated. OBJECTIVE:The obje...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0203
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Striking changes occurred in health care in the United States between 2000 and 2013, including growth of hospice and hospital-based palliative care teams, and changes in Medicare payment policies. OBJECTIVE:The aim of this study was to compare informants' reports and ratings of the quality of end-of-life ca...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0039
更新日期:2015-08-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0235
更新日期:2014-01-01 00:00:00
abstract:: Background: Diabetes is increasingly prevalent globally, including in palliative care. Guidelines vary as to the ideal glycemic goals for patients near the end of life. The relationship between hyperglycemia and attributable symptoms late in life remains ill defined. ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0083
更新日期:2020-03-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662101300051889
更新日期:2001-04-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0581
更新日期:2019-09-01 00:00:00
abstract::Fentanyl is a lipophilic, short-acting, synthetic opioid with a piperidine chemical structure. Fentanyl is an effective analgesic for cancer pain, and newer formulations such as the transmucosal and buccal forms have shown efficacy for the management of cancer-related breakthrough pain. This article reviews the pharma...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2009.0051
更新日期:2009-10-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2013.0387
更新日期:2014-01-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662104322737223
更新日期:2004-02-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0225
更新日期:2020-09-29 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0546
更新日期:2013-09-01 00:00:00