Index

Note: Page numbers followed by “f” and “t” refer to figures and tables, respectively.

A

Acid–base homeostasis, 102
Acupuncture, 73
Acute pain, 68
Acute skin toxicities from radiation, 134–140, 135f, 136f
See also Chronic skin toxicities from radiation
grading of toxicity, 136
Multinational Association for Supportive Care in Cancer (MASCC) guidelines for management, 138–139
pathology and timeline, 135–136
peak skin reaction, 135
prevention, 137–139
specific recommendations for patients undergoing treatment, 139–140, 139–140, 140, 140, 140, 140
tips on skin care, 139
treatment options, 139–140
ADAPT (talking map), 25–26
Advance care planning (ACP), 50
documents, 52–53
priorities and coordinated, 52
utilization of, 50–52
Advance directives (ADs), 50
documents, 52–53
patient characteristics and, 51
systematic review of the impact of, 52
Airway stents, 110–111
Aloe vera, 138
Alpha emitters, 204–205
radium-223, 204–205
American College of Radiology (ACR), 14
American Society for Radiation Oncology (ASTRO), 14, 41
Anorectal cancer, 244–249
metastasis, 245–246
as recurrent disease, 245
treatment recommendations, 247t
Argon plasma coagulation (APC), 111, 122
“ASK-TELL-ASK” method, 23–24
Asymptomatic metastases, 222–224

B

Beta emitters, 202–204
rhenium-186 (Re-186), 204
samarian-153 (Sm-153), 203–204, 204
strontium-89 (Sr-89), 202–203, 203
Biliary obstruction, 243
palliative radiation therapy for, 243–244
Bisacodyl, 96t
Bisphosphonates, 205
Bladder cancer, 266–267
Bleeding
assessment, 120–121
communication with patients about catastrophic bleeding events, 120–121
fractionation schemes for palliative radiation therapy, 11t
goals of care, 120–121
local therapies
dressings, 121
endoscopic procedures, 122
packing, 121
radiation therapy, 121–122
surgical procedures, 123
topical agents, 121
transcutaneous embolization of vessels, 122–123
scope of problem, 119–120
systemic therapies and considerations, 127–128
antifibrinolytics, 127–128
causative or exacerbating agents, discontinuation, 128
tranexamic acid, 127–128
vitamin K, 127
treatment options by site of hemorrhage
embolization of branches, 127
gastrointestinal bleeding, 126
hematuria, 126–127
hemoptysis, 124–125
intravesicular instillation of alum or prostaglandins, 127, 127
palliative radiotherapy fractionation for, 126t
palliative radiotherapy regimens, 126, 126t
renal artery embolization, 127
skin lesions, 123–124
uterine or iliac artery embolization, 125
vaginal bleeding, 125
Block, Dr. Susan, 44–45
Brachytherapy, 265
for head and neck cancers, 287–288
intraluminal, 115
Brain metastasis/bone metastases, 153
clinical assessment, 190–192
imaging modality, 192
Mirels’ Scoring System, 191–192, 191t
evaluation, 154, 190
evaluation and management of common clinical concerns, 156–164, 164t
anorexia, 159–160, 160t
antinausea and antiemetic management, 158t
conjunctivitis, 161–162
fatigue, 161
functional deficits, 162–164
headache characteristics, 158t
lethargy, 161, 161t
nausea and vomiting, 157–159
otitis externa, 162
seizure, 160–161
somnolence, 161, 161t
tearing, 161–162
management, 192–193, 197t
alpha emitters, 204–205
beta emitters, 202–204
bisphosphonates, 205
bisphosphonates in combination with EBRT, 205–206
denosumab, 206
exceptions in radiation therapy, 195–196
external beam radiation therapy (EBRT), 193, 198–199, 201–202
pain control, 192
preferred treatment regimen for noncomplicated, 195
prospective trials, 200–201
QOL improvement, 198–199
radiopharmaceuticals for diffuse painful metastases, 202
randomized controlled trials on fractionation regimens, 193–195, 194t
re-irradiation, 199–200, 199, 200, 200, 200
side effects of radiation therapy, 196–198
stereotactic body radiotherapy/stereotactic radiosurgery, 200–201
zoledronic acid, 205, 205
palliative radiotherapy regimens for
hypofractionated stereotactic radiotherapy (hSRT), 156
partial brain radiation therapy, 155, 155f
stereotactic radiosurgery (SRS), 155–156
whole brain radiation therapy (WBRT), 154
pathophysiology, 190
presentation, 190
Brief Pain Inventory, 69
Bronchoplasty or balloon dilation, 110
Bronchoscopy, 110, 122
Burden of cancer, 3
patient’s overall symptom burden, 60

C

CAGE substance abuse screening tool, 70
Calendula, topical, 138
Central airway obstruction (CAO), 103–104
diagnosis, 109
diagnostic tests, 109
three-dimensional reconstruction of CT images, 109
management, 109–115
airway stents, 110–111
argon plasma coagulation (APC), 111
brachytherapy (intraluminal), 115
bronchoplasty or balloon dilation, 110
bronchoscopy, 110
endobronchial cryotherapy, 112
helium–oxygen gas mixture therapy, 115
initial stabilization, 109
laser therapy, 111
palliative chemotherapy, 112–113
palliative radiotherapy, 113–115, 113t
palliative surgery, 112
silicone stents, 111
significance, 108–109
Central biliary obstruction, 249
Central pain, 68
“Choosing Wisely” campaign, 14
Chronic pain, 68
Chronic skin toxicities from radiation, 140–144
See also Acute skin toxicities from radiation
grading system, 141–142
LENT/SOMA, 143t
RTOG/EORTC, 142t
late toxicity, 140, 141f
prevention of, 143
LENT/SOMA (symptom specific—fibrosis/scar), 143t
pathology, 140–141
treatment, 143–144
use of vitamin E and pentoxifylline, 144
Clinical prediction, 4
Colonoscopy, 122
Combined directives, 52
Communication with patient
about catastrophic bleeding events, 120–121
ADAPT (talking map), 25–26
approaching the topic of prognosis, 25–26
“ASK-TELL-ASK” method, 23–24
conducting a family meeting/goals of care discussion, 26–27
delivering “bad news”, 24–25
FICA Spiritual History Tool, 27–28
NURSE, 25, 61
responding to patient emotions with empathy, 25
SPIKES, 24–25
Constipation, as radiation-induced adverse effects
definition, 92–93
diagnosis, 92–93
formal methods of assessment for, 94t
peristalsis-stimulating laxatives, 96t
presentation of, 93–94
prevalence, 93–94
rectal laxatives, 96t
Rome III criteria for functional, 92–93, 93, 93t
stool softening laxatives, 95t
treatment, 94–96
Costochondritis, 225
C-reactive Protein (CRP), 32
Curative radiation vs palliative radiation, 57, 58
Cyproheptadine, 160t
Cystoscopy, 122

D

Danthron, 96t
Decision-making in palliative care, 61
Denosumab, 206
Dexamethasone, 98t, 158t
Diarrhea, as radiation-induced adverse effects
American Society for Clinical Oncology Guidelines for management, 91f
common toxicity criteria, 90t
complicated, management of, 92
definition, 89
diagnosis, 89
presentation, 89–90
prevalence, 89–90
preventative measures against, 92t
progression, 89–90
symptoms of, 90
treatment, 90–92
Diphenoxylate, 90
Discharge, reasons for, 48
Distress, defined, 59
Docusate, 95t
Dolasetron, 98t
Dronabinol, 160
Durable Power of Attorney for Health Care (DPAHC), 52
Dutch Bone Metastasis Study Group, 5t
Dysgeusia, 290–291
Dysphagia, See Malignant dysphagia
Dyspnea, 101–102
American Thoracic Society definition, 101
evaluation of, 102–103
cardiopulmonary history and physical examination, 103
diagnostic testing, 103
scales, 102, 102, 102, 103
management of potentially reversible etiologies of, 103–104, 104t
management of symptoms
benzodiazepines, 106–107
nonpharmacologic therapies, 108
opioids, 105–106, 106t
oxygen therapy, 107
pathophysiology of, 102
symptoms, 101–102

E

Edmonton pain assessment scale, 69
Edmonton Symptom Assessment Score (ESAS), 60
Electron cone therapy, 265
Emetic risk categories of radiation, 97t
Endobronchial brachytherapy (EBB), 216–217, 217
Endobronchial cryotherapy, 112
EORTC Quality of life measures and for bone metastases, 60
Epidural spinal cord compression (ESCC)
See also Metastatic epidural spinal cord compression (MESCC)
common presenting symptoms
myelopathy/neurological impairment, 171
pain, 170–171
definition, 170
grading system, 170t
Frankel classification, 171
Esophageal cancer, 232–236
Esophagitis, as radiation-induced adverse effects, 225
definition, 85–89
diagnosis, 85–89
prevalence/progression, 87
symptoms and symptom management for, 86, 89t
treatment, 89
World Health Organization (WHO) Scale, 86t
Esophagogastroduodenoscopy (EGD), 122
External beam radiation therapy (EBRT), 193, 201–202, 232, 234, 234–235, 234–235, 242
benefits of, 198–199
bisphosphonates in combination with, 205–206
efficacy and toxicity of, 235

F

FICA Spiritual History Tool, 8, 8t, 27–28
Fluoroscopic simulation, 13
5-Flurouracil (5-FU), 235

G

Gastric cancer, 236–237, 237
Gastrointestinal (GI) tract malignancies, 231
Genitourinary malignancies, 266
summary of dose and fractionation of palliative regimens, 270t
on treatment management, 271t
treatment planning, 269–271
Graded Prognostic Assessment, 5t
Granisetron, 98t
Gynecologic and genitourinary (GU) cancers, 257, 257–258
See also Genitourinary malignancies, Gynecologic malignancies
evaluation
all patient, 259
female patient, 258
male patient, 259
treatment recommendations, 259–271
radiation therapy (RT) for, 258
Gynecologic malignancies, 259–265
brachytherapy, 265
dose and fractionation of palliative regimens for, 260t
external beam regimens, 264–265
Quad shot, 263–264
10 Gy in a single fraction, 261–263, 261f
electron cone therapy, 265
recurrent disease, 265–266

H

Hair follicles, 133–134
Head and neck cancers and skin metastases
airway/breathing obstruction, 277
bleeding, 277
common symptoms, 281t
expected acute side effects from radiation, 288–291
dermatitis, 288–289
dysgeusia, 290–291
laryngeal edema, 290
mucositis, 289
xerostomia, 290
fiberoptic nasolaryngoscopy, 280
general history and physical exam, 275–280
goals of care, 280–281
locoregional recurrences, 283
nausea, 278–279
neurologic impairment, 279–280
nutrition/weight loss, 279
pain, 276–277
performance status, 280–281
speech impairments, 277–278
swallowing, 278
on treatment management, 292t
corticosteroids, 291
multidisciplinary, 291
oral care, 291–293
skin care, 291
treatment recommendation, 281–288
brachytherapy, 287–288
concurrent chemotherapy with re-irradiation, 284
form of primary treatment failure, 283
full-dose re-irradiation, 283–284
important trials, 284–285
palliative chemotherapy, 282–283
radiotherapy for aggressive local control or potentially cure, 283–285
RT with palliative intent, 285–287, 286t
stereotactic body radiotherapy (SBRT), 287–288
supportive care, 281–282
Health care Power of Attorney, 52
Health Care Proxy (HCP), 52
Helium–oxygen gas mixture therapy, 107, 115
Hemoptysis, 217–218
Hepatocellular carcinoma (HCC), 242–244
Hospice care, 39–40, 63
Hospice referral
documenting decline, 45–46
medical guidelines for determining appropriateness of, 46
Hospice services, 47
barriers to enrollment, 48–49
interdisciplinary care team, 47
outcomes in patients receiving hospice care, 49
reasons for discharge, 48
setting, 47–48
home, 47
inpatient, 48
nursing home, 48
residential hospice, 48
5-HT3 receptor antagonists, 97–98, 98t
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

Lactulose, 95t
Laryngeal edema, 290
Laser therapy, 111
Leukocytosis/lymphopenia, 32
Life expectancy, 4
See also Prognostication
tools to assess, 5t
Liver metastases, 246–249
treatment recommendation for
central biliary obstruction, 249
criteria for surgical removal, 246–248
surgical resection, 246–248
on treatment management, 249, 251t
whole liver irradiation (WLI) with EBRT, 249
Y-90 radioembolization, 248
Living Will (LW), 52
Loperamide, 90
Lorazepam, 107, 158t
Lubiprostone, 95t
Lung cancer, advanced or metastatic
chronic management of toxicities, 226t
evaluation, 211–213
complaints of dysphagia, 213
general history and physical exam, 211–213
hoarseness, 213
presenting symptoms, 212
of superior vena cava syndrome (SVCS), 212–213
expected acute side effects of radiation therapy, 224
on-treatment management, 224–227, 226t
for respiratory symptoms, 225–227
treatment recommendations
for asymptomatic metastases, 222–224
chance of toxicities, 216
commonly used and/or studied fractionation schemes, 214t
endobronchial brachytherapy (EBB), 216–217, 217
for general pulmonary symptoms, 213–217
for hemoptysis, 217–218
for mesothelioma, 218–220
for postobstructive pneumonia, 218
for superior vena cava syndrome, 220–222
survival differences, 215–216

M

Magnesium hydroxide, 95t
Malignant dysphagia, 232–236
management of, 233t
external beam radiation therapy (EBRT), 234, 234–235, 234–235
high dose rate brachytherapy (HDR-BT), 233
low dose rate brachytherapy (LDR-BT), 234
radiation therapy for, 232–235
side effects of radiotherapy to the esophagus, 235–236
Malignant spinal cord compression, 169–170
Marinol, 160
MD Anderson Symptom Assessment Scores, 60
Medicare hospice benefit (MHB)
average hospice per diem reimbursement, 47
criteria for enrollment, 46–47
Megestrol Acetate, 160t
Mesothelioma, 218–220
Metastatic epidural spinal cord compression (MESCC), 169
evaluation
comprehensive physical examination, 172
history, 172
imaging, 173–175
management, 175–183
administration of dexamethasone, 175–176
palliative radiotherapy, 176–179
re-irradiation, 183, 183, 184
surgery, 180–182
surgical stabilization, 182–183
prognostic factors, 171–172
prognostic score to predict ambulatory status for MESCC, 174t
prognostic score to predict overall survival, 173t
recurrence after initial radiotherapy for, 183–184
Metastatic Spinal Cord Compression Index, 5t
Methylphenidate, 161t
Metoclopramide, 97–98, 98t, 158t
Midazolam, 106, 106, 106–107
Modafinil, 161t
Mucositis, as radiation-induced adverse effects, 289
clinical progression of RT-induced, 87t
definition, 85–89
diagnosis, 85–89
evidence-based clinical practice guidelines for care of patients, 88t
inflammation of the mucous membranes, 86
prevalence/progression, 86–87
radiation dosimetry and toxicity risk, 87t
treatment, 87–88
World Health Organization (WHO) Scale, 86t

N

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, 98t
emetic risk categories of radiation, 97t
incidence, 96–97
risk factors, 97
treatment, 97–98
Neuropathic pain, 68
Nociceptive pain, 68
Nonverbal pain assessment tools, 60
Number of Risk Factors model (NRF), 34, 34t
Number of Risk Factors (NRF), 5t
Numerical Rating Scale (NRS), 68
NURSE, 25, 61

O

Olanzapine, 158t
Olsalazine, 92t
Ondansetron, 98t, 158t
Opioid risk tool, 70
Opioid use disorder, managing patients with, 70
Oral Mucositis Assessment Scale (OMAS), 86

P

Pain
acute, 68
assessment, 68–70
case scenarios, 73–74, 74–76, 76, 77, 77, 77, 78–80
minimum requirements, 69
recommended screening tools, 70
safety and concerns, 69–70
central, 68
chronic, 68
definition, 67–68
management of, 71–73
acupuncture, 73
adjuvant analgesics and their use in various types of pain, 80t
consultation with pain management specialists, 80
equianalgesic dosing table, 72t
interventional pain management, 73
methadone dosing, 79t
music therapy, 73
nonpharmacologic, 73
opioid adverse effects and possible treatment options, 75t
opioids—initial dosing recommendations for, 71t
pharmacologic, 71–73
suggested starting doses for nonopioids, 72t
using analgesics, 78t
WHO analgesic “ladder” for cancer pain relief, 71–72
neuropathic, 68
nociceptive, 68
Pain flare, 13–14
Palliative care assessment, 59–62
assessment of symptoms, 60
patient/family understanding of current illness status, 60–61, 60, 60, 60–61, 61
screening, 59
tools, 60, 60
Palliative care (PC), 40
alleviating pain and suffering, 8
barriers to, 42
decision-making in, 61
definitions, 40–41
Centers for Medicare and Medicaid Services (CMS), 40–41
Center to Advance Palliative Care, 41
Center to Advance Palliative Care (CAPC), 58
World Health Organization (WHO), 40, 58–59
emerging technologies, 12–13
ENABLE III trial, 43
ENABLE II trial, 43
function of, 4
goals of care and collaboration with palliative care teams, 58
guidelines, 41
interdisciplinary team, 42
need for, 14
outcomes, 42–44
patient’s overall goals of care, 62
religion and spirituality, role of, 4–8
services, 41–42
setting, 42
Palliative Performance Scale (PPS), 5t
Palliative Prognostic Index (PPI), 5t, 33–34
Palliative Prognostic Score (PaP), 5t, 33
prognostic model, 33t
Palliative radiation therapy, 8–10, 57–63, 113–115
See also Radiation-induced adverse effects
for biliary obstruction, 243–244
for bladder cancer, 266–267
for collapsed lung, 114
common dose and fractionation schemes, 113t
curative radiation vs, 57, 58
Dutch Bone Metastasis Study, 8–9, 9t
efficacy of, 10–12, 62
fractionation schemes
for bleeding, 11t
for bone metastasis, 10t
for brain metastasis, 11t
for lung tumors, 11t
for spinal cord compression, 10t
guidelines and quality measures, 14–15
bone metastasis, 14
end of life radiation therapy, 14–15
for head and neck cancers and skin metastases, 285–287
expected acute side effects from radiation, 288–291
guide to palliative RT regimens, 286t
for intubated patient, 114
for MESCC, 176–179
candidates for, 180b
data from prospective studies, 178
data from randomized clinical trials, 177–178
data from retrospective studies, 179
dose/fractionation regimens, 177–179
planning technique, 176–177
side effects, 177
stereotactic radiosurgery/stereotactic body radiation therapy (SRS/SBRT), 179–180
pain relief following, 12, 12
for penile and urethral cancer, 269
planning and delivery, 13
for prostate cancer, 267–269
rates of palliation, 12
for renal cell carcinoma, 266
side effects, 13–14
late, 14
side effects associated with, 114
supportive care for intubated patient, 115
use of modern CT simulation and computerized treatment planning, 113–114
Palonosetron, 98t
Pancreatic cancer, 237–242
clinical trials, 238t
complications of locally destructive, 241, 241–242
local progression of, 237–241
borderline resectable pancreatic cancer (BRPC), 240
metastasis, 242
protocol for the treatment of, 240
symptom palliation, 241–242
Partial brain radiation therapy, 155, 155f
Patient/family’s prognostic awareness, 61
Patient-reported outcomes (PROs), 74
Penile and urethral cancer, 269
Petroleum ointments, 138
Physician accuracy, 30
Physician Orders for Life-Sustaining Treatment (POLST), 52–53
Poloxamer, 95t
Postobstructive pneumonia, 218
Prednisone, 160t, 161t
Prescribing Monitoring Program Registry (PMP), 73
Prochlorperazine, 97–98, 98t, 158t
Prognosis
See also Prognostication
communication with patient, 25–26
estimating, 30
prognostic indicators, 4
Prognosis in Palliative Care Study (PiPs), 5t
Prognostication, 4
estimating prognosis, 30
future directions on prognostic markers and prognostic models, 35–36
importance of, 29–30
information desired and desired manner of communication, 30
physician accuracy, 30
prognostic factors, 31–32
prognostic models, 32–35, 33t
comparison of, 35t
Number of Risk Factors model (NRF), 34, 34t
Palliative Prognostic Index (PPI), 33–34
Palliative Prognostic Score (PaP), 33, 33t
TEACHH model, 34–35, 35t
Prostate cancer, 267–269

R

Radiation-induced adverse effects
constipation
definition, 92–93
diagnosis, 92–93
formal methods of assessment for, 94t
peristalsis-stimulating laxatives, 96t
presentation of, 93–94
prevalence, 93–94
rectal laxatives, 96t
Rome III criteria for functional, 92–93, 93, 93t
stool softening laxatives, 95t
treatment, 94–96
diarrhea
American Society for Clinical Oncology Guidelines for management, 91f
common toxicity criteria, 90t
complicated, management of, 92
definition, 89
diagnosis, 89
presentation, 89–90
prevalence, 89–90
preventative measures against, 92t
progression, 89–90
symptoms of, 90
treatment, 90–92
esophagitis
definition, 85–89
diagnosis, 85–89
prevalence/progression, 87
symptoms and symptom management for, 86, 89t
treatment, 89
World Health Organization (WHO) Scale, 86t
mucositis
clinical progression of RT-induced, 87t
definition, 85–89
diagnosis, 85–89
evidence-based clinical practice guidelines for care of patients, 88t
inflammation of the mucous membranes, 86
prevalence/progression, 86–87
radiation dosimetry and toxicity risk, 87t
treatment, 87–88
World Health Organization (WHO) Scale, 86t
nausea and vomiting (RINV)
antiemetic dosing by radiation risk category, 98t
emetic risk categories of radiation, 97t
incidence, 96–97
risk factors, 97
treatment, 97–98
Radiation recall dermatitis, 144–145
agents associated with reactions, 144f
for bleeding events, 121–122
fractionation schemes, 121–122, 121, 121, 122
gastric cancer, 236–237
for malignant dysphagia, 232–235
palliative, 8–10
side effects to stomach, 237
side effects to the esophagus, 235–236
Radium-223, 204–205
Recursive Partitioning Analysis, 5t
Religion, role in PC, 4–8
Renal cell carcinoma, 266
Rhenium-186 (Re-186), 204

S

Salicylates, 92t
Samarian-153 (Sm-153), 203–204, 204
Saunders, Cicely, 39–40
Scopolamine, 158t
Sebaceous glands, 133–134
Senna, 94, 96t
Silicone stents, 111
Skin, structure of, 133–134, 134f
Skin toxicity, radiation-induced
grading of toxicity, 136
Multinational Association for Supportive Care in Cancer (MASCC) guidelines for management, 138–139
pathology and timeline, 135–136
peak skin reaction, 135
prevention, 137–139
specific recommendations for patients undergoing treatment, 139–140, 139–140, 140, 140, 140, 140
tips on skin care, 139
treatment options, 139–140
chronic, 140–144
grading system, 141–142
LENT/SOMA grading system, 143t
LENT/SOMA (symptom specific—fibrosis/scar), 143t
pathology, 140–141
prevention of late toxicity, 143
RTOG/EORTC grading system, 142t
cutaneous inflammatory reaction, 136t
dermatitis, 288–289
grading of toxicity, 136
Common Toxicity Criteria for Adverse Events (CTCAE) version 4, 136, 136t
RTOG/EORTC grading system, 136, 137t
incidence rate, 133
palliative doses and, 134
radiation recall dermatitis, 144–145
agents associated with reactions, 144f
Sodium picosulfate, 96t
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
Stereotactic body radiation therapy (SBRT), 12–13, 114, 179–180, 200–201
for hepatocellular carcinoma (HCC), 243
for liver metastases, 248–249, 250t
for pancreatic cancer, 239, 239, 240–241, 240–241, 241
Stereotactic body radiotherapy (SBRT)
for head and neck cancers, 287–288
Stereotactic radiosurgery (SRS), 155–156, 179–180, 200–201
Strontium-89 (Sr-89), 202–203, 203
Sucralfate, 92t
Sucralfate, topical, 138
Sulfasalazine, 92t
Sulfate, 95t
Superior vena cava syndrome, 220–222
Surgical decompression, 180–182
candidates for, 180b
combined with radiotherapy, 182
decompressive laminectomy, 181
indications for, 180b
treatment paradigm, 181–182
Survival Prediction Score (SPS), 5t
Sweat glands, 133–134
Systemic chemotherapy, 242

T

TEACHH model, 5t, 34–35, 35t
Tegaserod, 96t
Telangiectasias, 141
Terminal syndrome, 4
Transarterial chemoembolization (TACE), 242
Transcutaneous embolization of vessels, 122–123
limitations, 123
mechanical devices and materials, 122
Trolamine, 137–138
Tropisetron, 98t

V

Visual Analog Scale (VAS), 68, 103

W

Whole brain radiation therapy (WBRT), 154, 163–164, 163, 164
Whole liver irradiation (WLI) with EBRT, 249
Wong-Baker FACES Scale, 68

X

Xerostomia, 290

Y

Yittrium-90 (Y-90) radioembolization, 242–243, 242, 248
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