Index
Note: Page numbers followed by “f” and “t” refer to figures and tables, respectively.
A
Acid–base homeostasis,
102
Multinational Association for Supportive Care in Cancer (MASCC) guidelines for management,
138–139ADAPT (talking map),
25–26
Advance care planning (ACP),
50
priorities and coordinated,
52Advance directives (ADs),
50
patient characteristics and,
51systematic review of the impact of,
52
American College of Radiology (ACR),
14
American Society for Radiation Oncology (ASTRO),
14,
41
as recurrent disease,
245treatment recommendations,
247tArgon plasma coagulation (APC),
111,
122
“ASK-TELL-ASK” method,
23–24
B
rhenium-186 (Re-186),
204
palliative radiation therapy for,
243–244
Bleeding
communication with patients about catastrophic bleeding events,
120–121fractionation schemes for palliative radiation therapy,
11tlocal therapies
endoscopic procedures,
122transcutaneous embolization of vessels,
122–123
systemic therapies and considerations,
127–128
causative or exacerbating agents, discontinuation,
128
treatment options by site of hemorrhage
embolization of branches,
127gastrointestinal bleeding,
126intravesicular instillation of alum or prostaglandins,
127,
127palliative radiotherapy fractionation for,
126tpalliative radiotherapy regimens,
126,
126trenal artery embolization,
127uterine or iliac artery embolization,
125
Brain metastasis/bone metastases,
153
evaluation and management of common clinical concerns,
156–164,
164t
antinausea and antiemetic management,
158theadache characteristics,
158t
bisphosphonates in combination with EBRT,
205–206exceptions in radiation therapy,
195–196preferred treatment regimen for noncomplicated,
195radiopharmaceuticals for diffuse painful metastases,
202randomized controlled trials on fractionation regimens,
193–195,
194tside effects of radiation therapy,
196–198stereotactic body radiotherapy/stereotactic radiosurgery,
200–201
palliative radiotherapy regimens for
hypofractionated stereotactic radiotherapy (hSRT),
156partial brain radiation therapy,
155,
155fstereotactic radiosurgery (SRS),
155–156whole brain radiation therapy (WBRT),
154
Bronchoplasty or balloon dilation,
110
Burden of cancer,
patient’s overall symptom burden,
60C
CAGE substance abuse screening tool,
70
Central airway obstruction (CAO),
103–104
three-dimensional reconstruction of CT images,
109
argon plasma coagulation (APC),
111brachytherapy (intraluminal),
115bronchoplasty or balloon dilation,
110endobronchial cryotherapy,
112helium–oxygen gas mixture therapy,
115initial stabilization,
109
Central biliary obstruction,
249
“Choosing Wisely” campaign,
14
LENT/SOMA (symptom specific—fibrosis/scar),
143t
use of vitamin E and pentoxifylline,
144
Clinical prediction,
Communication with patient
about catastrophic bleeding events,
120–121ADAPT (talking map),
25–26approaching the topic of prognosis,
25–26“ASK-TELL-ASK” method,
23–24conducting a family meeting/goals of care discussion,
26–27delivering “bad news”,
24–25FICA Spiritual History Tool,
27–28responding to patient emotions with empathy,
25Constipation, as radiation-induced adverse effects
formal methods of assessment for,
94tperistalsis-stimulating laxatives,
96tstool softening laxatives,
95t
C-reactive Protein (CRP),
32
Curative radiation
vs palliative radiation,
57,
58
D
Decision-making in palliative care,
61
Diarrhea, as radiation-induced adverse effects
American Society for Clinical Oncology Guidelines for management,
91fcommon toxicity criteria,
90tcomplicated, management of,
92preventative measures against,
92t
Discharge, reasons for,
48
Durable Power of Attorney for Health Care (DPAHC),
52
Dutch Bone Metastasis Study Group,
5t
American Thoracic Society definition,
101
cardiopulmonary history and physical examination,
103
management of potentially reversible etiologies of,
103–104,
104tmanagement of symptoms
nonpharmacologic therapies,
108
E
Edmonton pain assessment scale,
69
Edmonton Symptom Assessment Score (ESAS),
60
Electron cone therapy,
265
Emetic risk categories of radiation,
97t
Endobronchial cryotherapy,
112
EORTC Quality of life measures and for bone metastases,
60
common presenting symptoms
myelopathy/neurological impairment,
171
Frankel classification,
171
Esophagitis, as radiation-induced adverse effects,
225
prevalence/progression,
87symptoms and symptom management for,
86,
89tWorld Health Organization (WHO) Scale,
86tEsophagogastroduodenoscopy (EGD),
122
bisphosphonates in combination with,
205–206efficacy and toxicity of,
235F
FICA Spiritual History Tool, ,
8t,
27–28
Fluoroscopic simulation,
13
5-Flurouracil (5-FU),
235
G
Gastrointestinal (GI) tract malignancies,
231
Genitourinary malignancies,
266
summary of dose and fractionation of palliative regimens,
270ton treatment management,
271tGraded Prognostic Assessment,
5t
evaluation
radiation therapy (RT) for,
258
dose and fractionation of palliative regimens for,
260t
electron cone therapy,
265H
Head and neck cancers and skin metastases
airway/breathing obstruction,
277expected acute side effects from radiation,
288–291
fiberoptic nasolaryngoscopy,
280general history and physical exam,
275–280locoregional recurrences,
283nutrition/weight loss,
279on treatment management,
292t
concurrent chemotherapy with re-irradiation,
284form of primary treatment failure,
283radiotherapy for aggressive local control or potentially cure,
283–285stereotactic body radiotherapy (SBRT),
287–288
Health care Power of Attorney,
52
Health Care Proxy (HCP),
52
Helium–oxygen gas mixture therapy,
107,
115
Hepatocellular carcinoma (HCC),
242–244
Hospice referral
documenting decline,
45–46medical guidelines for determining appropriateness of,
46
barriers to enrollment,
48–49interdisciplinary care team,
47outcomes in patients receiving hospice care,
49reasons for discharge,
48
Hyaluronic acid, topical,
138
Hypofractionated stereotactic radiotherapy (hSRT),
156
I
Interdisciplinary care team,
47
Intraluminal brachytherapy,
115
K
Karnofsky Performance Status (KPS),
31,
31
L
Leukocytosis/lymphopenia,
32
treatment recommendation for
central biliary obstruction,
249criteria for surgical removal,
246–248whole liver irradiation (WLI) with EBRT,
249Y-90 radioembolization,
248
Lung cancer, advanced or metastatic
chronic management of toxicities,
226t
complaints of dysphagia,
213general history and physical exam,
211–213of superior vena cava syndrome (SVCS),
212–213
expected acute side effects of radiation therapy,
224
treatment recommendations
for asymptomatic metastases,
222–224chance of toxicities,
216commonly used and/or studied fractionation schemes,
214tfor general pulmonary symptoms,
213–217for postobstructive pneumonia,
218for superior vena cava syndrome,
220–222
M
high dose rate brachytherapy (HDR-BT),
233low dose rate brachytherapy (LDR-BT),
234
side effects of radiotherapy to the esophagus,
235–236Malignant spinal cord compression,
169–170
MD Anderson Symptom Assessment Scores,
60
Medicare hospice benefit (MHB)
average hospice per diem reimbursement,
47criteria for enrollment,
46–47
Metastatic epidural spinal cord compression (MESCC),
169
evaluation
comprehensive physical examination,
172
administration of dexamethasone,
175–176
prognostic score to predict ambulatory status for MESCC,
174tprognostic score to predict overall survival,
173t
recurrence after initial radiotherapy for,
183–184Metastatic Spinal Cord Compression Index,
5t
Mucositis, as radiation-induced adverse effects,
289
clinical progression of RT-induced,
87tevidence-based clinical practice guidelines for care of patients,
88tinflammation of the mucous membranes,
86prevalence/progression,
86–87radiation dosimetry and toxicity risk,
87tWorld Health Organization (WHO) Scale,
86tN
National Cancer Institute (NCI) Common Toxicity Criteria (CTC) instrument,
86
National Comprehensive Cancer Network (NCCN) NSCLC Outcomes Database,
15
National Consensus Project for Quality Palliative Care,
41
National Hospice Study (NHPCO),
5t
National Quality Forum (NQF),
14
Nausea and vomiting (RINV), radiation-induced
antiemetic dosing by radiation risk category,
98temetic risk categories of radiation,
97t
Nonverbal pain assessment tools,
60
Number of Risk Factors model (NRF),
34,
34t
Number of Risk Factors (NRF),
5t
Numerical Rating Scale (NRS),
68
O
Opioid use disorder, managing patients with,
70
Oral Mucositis Assessment Scale (OMAS),
86
P
Pain
recommended screening tools,
70safety and concerns,
69–70
adjuvant analgesics and their use in various types of pain,
80tconsultation with pain management specialists,
80equianalgesic dosing table,
72tinterventional pain management,
73opioid adverse effects and possible treatment options,
75topioids—initial dosing recommendations for,
71tsuggested starting doses for nonopioids,
72tWHO analgesic “ladder” for cancer pain relief,
71–72
Palliative care assessment,
59–62
assessment of symptoms,
60patient/family understanding of current illness status,
60–61,
60,
60,
60–61,
61
alleviating pain and suffering,
Centers for Medicare and Medicaid Services (CMS),
40–41Center to Advance Palliative Care,
41Center to Advance Palliative Care (CAPC),
58World Health Organization (WHO),
40,
58–59
emerging technologies,
12–13function of,
goals of care and collaboration with palliative care teams,
58interdisciplinary team,
42patient’s overall goals of care,
62religion and spirituality, role of,
4–8Palliative Performance Scale (PPS),
5t
Palliative Prognostic Index (PPI),
5t,
33–34
Palliative Prognostic Score (PaP),
5t,
33
common dose and fractionation schemes,
113tcurative radiation
vs,
57,
58Dutch Bone Metastasis Study,
8–9,
9tfractionation schemes
for brain metastasis,
11tfor spinal cord compression,
10t
guidelines and quality measures,
14–15
end of life radiation therapy,
14–15
for head and neck cancers and skin metastases,
285–287
expected acute side effects from radiation,
288–291guide to palliative RT regimens,
286t
for intubated patient,
114
data from prospective studies,
178data from randomized clinical trials,
177–178data from retrospective studies,
179dose/fractionation regimens,
177–179stereotactic radiosurgery/stereotactic body radiation therapy (SRS/SBRT),
179–180
pain relief following,
12,
12for penile and urethral cancer,
269planning and delivery,
13for renal cell carcinoma,
266
side effects associated with,
114supportive care for intubated patient,
115use of modern CT simulation and computerized treatment planning,
113–114
complications of locally destructive,
241,
241–242
borderline resectable pancreatic cancer (BRPC),
240
protocol for the treatment of,
240Partial brain radiation therapy,
155,
155f
Patient/family’s prognostic awareness,
61
Patient-reported outcomes (PROs),
74
Penile and urethral cancer,
269
Physician Orders for Life-Sustaining Treatment (POLST),
52–53
Postobstructive pneumonia,
218
Prescribing Monitoring Program Registry (PMP),
73
communication with patient,
25–26prognostic indicators,
Prognosis in Palliative Care Study (PiPs),
5t
Prognostication,
future directions on prognostic markers and prognostic models,
35–36information desired and desired manner of communication,
30prognostic factors,
31–32
Number of Risk Factors model (NRF),
34,
34tPalliative Prognostic Index (PPI),
33–34Palliative Prognostic Score (PaP),
33,
33t
R
Radiation-induced adverse effects
constipation
formal methods of assessment for,
94tperistalsis-stimulating laxatives,
96tstool softening laxatives,
95t
diarrhea
American Society for Clinical Oncology Guidelines for management,
91fcommon toxicity criteria,
90tcomplicated, management of,
92preventative measures against,
92t
esophagitis
prevalence/progression,
87symptoms and symptom management for,
86,
89tWorld Health Organization (WHO) Scale,
86t
mucositis
clinical progression of RT-induced,
87tevidence-based clinical practice guidelines for care of patients,
88tinflammation of the mucous membranes,
86prevalence/progression,
86–87radiation dosimetry and toxicity risk,
87tWorld Health Organization (WHO) Scale,
86t
nausea and vomiting (RINV)
antiemetic dosing by radiation risk category,
98temetic risk categories of radiation,
97t
Radiation recall dermatitis,
144–145
agents associated with reactions,
144f
side effects to stomach,
237side effects to the esophagus,
235–236
Recursive Partitioning Analysis,
5t
Religion, role in PC,
4–8
Renal cell carcinoma,
266
Rhenium-186 (Re-186),
204
S
Skin toxicity, radiation-induced
Multinational Association for Supportive Care in Cancer (MASCC) guidelines for management,
138–139
LENT/SOMA grading system,
143tLENT/SOMA (symptom specific—fibrosis/scar),
143tprevention of late toxicity,
143RTOG/EORTC grading system,
142t
cutaneous inflammatory reaction,
136t
Common Toxicity Criteria for Adverse Events (CTCAE) version 4,
136,
136tRTOG/EORTC grading system,
136,
137t
palliative doses and,
134radiation recall dermatitis,
144–145
agents associated with reactions,
144f
SPIKES-A six-step protocol,
24–25
Spinal instability neoplastic score (SINS),
182–183
Spiritual care experts,
7–8
Spirituality, role in PC,
4–8
for hepatocellular carcinoma (HCC),
243Stereotactic body radiotherapy (SBRT)
Superior vena cava syndrome,
220–222
combined with radiotherapy,
182decompressive laminectomy,
181Survival Prediction Score (SPS),
5t
Systemic chemotherapy,
242
T
Terminal syndrome,
Transarterial chemoembolization (TACE),
242
Transcutaneous embolization of vessels,
122–123
mechanical devices and materials,
122
V
Visual Analog Scale (VAS),
68,
103
W
Whole liver irradiation (WLI) with EBRT,
249
Wong-Baker FACES Scale,
68
X
Y