Authors
Introduction: Over 40% of the HNC patients need palliation at presentation by judicious use of CDT, symptom control and addressing of psychosocial factors. An audit of palliation of HNC patients is presented.
Aims: To assess the impact of CDT and supportive care on symptom relief and survival of advanced HNC patients.
Methodology: Data was collected from case records to study the demography and symptomatology. Intervention - feeding tube, tracheostomy, CDT, analgesic etc were noted. Symptom relief following CDT/supportive measure was the primary endpoint. Data was analyzed as of Sept’14. Result: 109 patients were seen between Jan’13 to Aug’14. Median age was 52 yrs; 92% males; co-morbidities seen in 20% cases; 80% cases needed assistance for their normal activities; 90% had stage IV disease (7% metastasis). Symptoms - pain (87%), difficulty in swallowing (40%) and fungation (30%), aspiration (25%), and depression and sleep disturbance (40%). Median duration of symptoms was 4 months. CDT was offered in 96 patients. 49 (51%) received chemotherapy (weekly methotrexate (MTX)) alone and 47 (49%) received MTX chemo and short course RT (20Gy/5 fractions). For pain, paracetamol and morphine combination was used. CDT and analgesic cover provided pain relief in 75% cases. Response to treatment was seen in over 50% cases. At the time of analysis, 30% were alive, 57 % dead and 13% lost to follow up.
Conclusion: CDT and supportive measures was effective in providing symptom relief.
- Punita Lal1,
- Mranalini Verma1,
- Resham Srivastava1,
- Shaleen Kumar1
- Sanjay Gandhi Postgraduate Institute of Medical Sciences1
2015
ExcerptIntroduction: Over 40% of the HNC patients need palliation at presentation by judicious use of CDT, symptom control and addressing of psychosocial factors. An audit of palliation of HNC patients is presented.
Aims: To assess the impact of CDT and supportive care on symptom relief and survival of advanced HNC patients.
Methodology: Data was collected from case records to study the demography and symptomatology. Intervention - feeding tube, tracheostomy, CDT, analgesic etc were noted. Symptom relief following CDT/supportive measure was the primary endpoint. Data was analyzed as of Sept’14. Result: 109 patients were seen between Jan’13 to Aug’14. Median age was 52 yrs; 92% males; co-morbidities seen in 20% cases; 80% cases needed assistance for their normal activities; 90% had stage IV disease (7% metastasis). Symptoms - pain (87%), difficulty in swallowing (40%) and fungation (30%), aspiration (25%), and depression and sleep disturbance (40%). Median duration of symptoms was 4 months. CDT was offered in 96 patients. 49 (51%) received chemotherapy (weekly methotrexate (MTX)) alone and 47 (49%) received MTX chemo and short course RT (20Gy/5 fractions). For pain, paracetamol and morphine combination was used. CDT and analgesic cover provided pain relief in 75% cases. Response to treatment was seen in over 50% cases. At the time of analysis, 30% were alive, 57 % dead and 13% lost to follow up.
Conclusion: CDT and supportive measures was effective in providing symptom relief.