881 Could antineoplastic therapy integrate palliative care for symptom relief in advanced/refractory cancer patients?

• Published in: European journal of cancer (1990) Vol. 31; p. S184
• Main Authors: Abbadessa, A., Corazzelli, G., Muscherà, R., Giordano, S., Arcidiacone, G.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-11-1995
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/0959-8049(95)96130-6

1) to offer continuity of care and in- and outpatients services to far-advanced end stage cancer patients, bridged by double employment of the same oncology/palliative care physicians and nurses; 2) to integrate a patient-tailored anticancer treatment to supportive and palliative care for relieving disease-related distressing symptoms on account of patients’ expressed needs and wishes.
86 patients suffering from active, progressive far-advanced cancer: refractory NHL: 7; AIDS-related-NHL: 1; CML in blast crisis: 3; elderly AML patients with resistant disease: 9; lung: 18; gastrointestinal: 23; renal: 1; urinary tract: 6, head and neck: 4; metastatic breast: 2; ovarian carcinomatosis: 7; melanoma: 1; unknown primary: 4.
1) Different options for setting were offered by the same multidisciplinary team: 1) traditional hospital setting; 2) continuous home-care; 3) hospitalization at home. 2) Anticancer chemotherapy: low dose reduced-toxicity different regimens have been proposed to patients with chemoresponsive tumour with the only objective of the symptoms relief. Adequate supportive therapy, transfusional and antimicrobial, has been provided to hematological pts at home. 3) Palliative medicine was given to all the patients for the control of symptoms and for terminal illness, both in hospital and at home.
55 patients (62%) agreed to receive palliative chemotherapy (38 in hospital, 17 at home). A symptomatical response rate of 64% has been achieved. Patients receiving no anticancer treatment experienced comparable symptoms but a higher grade of distress (in one or more of the items of Symptom Distress Scale) to those patients who were on palliative chemotherapy. In our opinion the value of symptomatic response achieved with chemotherapy should not be decried and a more close integration between oncologists and palliative care teams could prove fair for patients.