Palyatif Bakım ile Performans Skoru İyileşen Metastatik Küçük Hücreli Akciğer Karsinomlu Hasta

Palyatif bakım, iyileştirici tedavilerin tükenmesinin ardından başlayan, hastaların yaşamlarının son dönemlerinde ortaya çıkan sorunlarına semptomatik ve rahatlatıcı çözümler üreten hizmetler bütünüdür. Hasta, 1 yıl önce küçük hücreli akciğer karsinomu tanısı almış, kemoterapi ve radyoterapi tedavisi sonrası kitle kaybolmuş. Altı ay sonra kontrole gelen hastada uzak metastaz tespit edilmiş. Hastanın başvuru anında genel durumunun kötü olması, performans skorunun düşük olması nedeni ile kemoterapi başlanması düşünülmemiş. Hasta palyatif tedavi amacı ile merkezimize gönderildi. Multidisipliner yaklaşımla, fizyoterapist, psikolog, nütrisyon komitesi eşliğinde tedavi uygulandı. Hastanın klinik takiplerinde performans skoru iyileşti. Onkoloji bölümü ile görüşülerek hastanın kemoterapisine yeniden başlandı

A Patient with Metastatic Small Cell Lung Cancer whose Performance Score İmproves with Palliative Care

Palliative care, symptomatic and relief treatment, applied after failure of medical treatment in last period of living patients.A year ago, the patient was diagnosed with small-cell carcinoma in lung. This patient was treated with chemotherapy and radiotherapy by specialist doctor and the mass was disappeared. Six months after the treatment, the patient's control examination has been performed and distant metastases were been detect. He has got bad general condition and low performance score. For this reason, no treatment has been planned by oncologist. He was refered to paliative treatment center. Multydisipliner treatment was appleid by physioterapist, psikolog and nutricion comite in palliative center. Performance score of patient's healed with palliative treatment. Then, he was referred to oncologist for chemoterapy treatment.

___

  • WHO definition of palliative care;1998 www.who.int/cancer/palliative/definition/en/
  • Jackman DM, Johnson BE. Small-cell lung cancer. Lancet. 2005 Oct 15-21. 366(9494):1385-96.
  • Janne PA, Freidlin B, Saxman S, Johnson DH, Livingston RB, Shepherd FA, et al. Twenty-five years of clinical research for patients with limited-stage small cell lung carcinoma in North America. Cancer. 2002 Oct 1. 95(7):1528-38.
  • Ferrell BR, Coyle N, eds. Oxford Textbook of Palliative Nursing. New York: Oxford University Press; 2010.
  • Quill TE, Abernethy AP. Generalist plus specialist palliative care creating a more sustainable model. N Engl J Med. 2013;368:1173-1175.
  • The Center to Advance Palliative Care (CAPC). Palliative care tools, training and technical assistance. 2014. http://www.capc.org Accessed August 14, 2014.
  • American College of Chest Physicians; Health and Science Policy Committee. Diagnosis and management of lung cancer. ACCP evidence-based guidelines. Chest. 2003 Jan;123(1 Suppl): D-G, 1S-337.
  • Bach PB et al. Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007 Sep;132(3 Suppl):69-77.
  • Boffetta P, Trichopoulos D. Cancer of the lung, larynx, and pleura. Adami H, Hunter D, Trichopoulos D, eds. Textbook of Cancer Epidemiology. 2nd ed. New York, NY: Oxford University Press; 2008. 349-67.
  • Cascone T, Gold KA, Glisson BS. Small Cell Carcinoma of the Lung. Kantarjian H, Wolff R, eds. The MD Anderson Manual of Medical Oncology. 3rd ed. New York, NY: McGraw-Hill