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Onkologische Welt 2024; 15(05): 295-300
DOI: 10.1055/a-2358-9877
Übersichtsarbeit

Palliativmedizinische Aspekte der Pneumo-Onkologie

Palliative aspects in pulmonary oncology
David Heigener
1   Zentrum für Pneumologie, Agaplesion Diakonieklinikum Rotenburg gGmbH, Rotenburg Wümme, Deutschland
,
Sandra Delis
2   Klinik für Palliativmedizin, Klinik für Pneumologie, Helios Klinikum Emil von Behring Berlin-Zehlendorf, Berlin, Deutschland
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ZUSAMMENFASSUNG

Die Palliativmedizin ist integraler Bestandteil der Therapie des fortgeschrittenen und metastasierten Lungenkarzinoms. Die strukturierte palliativmedizinische Begleitung der Patienten ab Diagnosestellung führt zu einer deutlich verbesserten Lebensqualität und eventuell sogar zu einer Verlängerung der Überlebenszeit. Neben der Symptomkontrolle sollte auch die Krankheitsperspektive regelmäßig neu evaluiert und mit dem Patienten und seinen Zugehörigen offen kommuniziert werden.

ABSTRACT

Palliative medicine is an essential part in the treatment of patients with advanced or metastatic NSCLC. A structured palliative approach beginning from diagnoses improves quality of life and maybe even prolong survival. Besides symptom control, the disease trajectory and prognosis should regularly be re-evaluated and discussed with the patient and his loved ones.

Schlüsselwörter

metastasiertes Lungenkarzinom - Palliativmedizin - Symptomkontrolle - Therapiebegrenzung

Key words

metastatic lunc cancer - palliative care - symptom control - therapy limitation


Publication History

Article published online:
03 September 2024

© 2024. Thieme. All rights reserved.

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  • Literatur

  • 1 Howlader N, Forjaz G, Mooradian MJ. et al The Effect of Advances in Lung-Cancer Treatment on Population Mortality.. N Engl J Med 2020; 383: 640-649 DOI: 10.1056/NEJMoa1916623.
    CrossrefPubMedGoogle Scholar
  • 2 Mouritzen MT, Carus A, Ladekarl M. et al Nationwide Survival Benefit after Implementation of First-Line Immunotherapy for Patients with Advanced NSCLC-Real World Efficacy.. Cancers (Basel) 2021; 13: 4846 DOI: 10.3390/cancers13194846.
    CrossrefPubMedGoogle Scholar
  • 3 Heigener DF, Reck M. Immunotherapy: the third wave in lung cancer treatment.. Lancet Respir Med 2015; 03: 923-924 DOI: 10.1016/S2213-2600(15)00429-4.
    CrossrefPubMedGoogle Scholar
  • 4 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020.. CA Cancer J Clin 2020; 70: 7-30 DOI: 10.3322/caac.21590.
    CrossrefPubMedGoogle Scholar
  • 5 Temel JS, Greer JA, Muzikansky A. et al Early palliative care for patients with metastatic non-small-cell lung cancer.. N Engl J Med 2010; 363: 733-742
    CrossrefPubMedGoogle Scholar
  • 6 Bruera E, Yennurajalingam S. Palliative care in advanced cancer patients: how and when?. Oncologist 2012; 17: 267-273 DOI: 10.1634/theoncologist.2011-0219.
    CrossrefPubMedGoogle Scholar
  • 7 Schuette W.. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms, Langversion 2.1. 2022. AWMF-Registernummer: 020/007OL
    Google Scholar
  • 8 Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft DK, AWMF). S3-Leitlinie: Palliativmedizin für Patienten mit einer nicht heilbaren Krebserkrankung. 1.0.Aufl. Leitlinienprogramm Onkologie der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF), Deutschen Krebsgesellschaft e. V. (DKG) und Deutschen Krebshilfe (DKH). 2015
  • 9 [Anonym]. Cancer pain relief. With a guide to opioid availability. 2nd. Aufl. Genova: WHO; 1996
  • 10 Galbraith S, Fagan P, Perkins P. et al Does the use of a handheld fan improve chronic dyspnea? A randomized, controlled, crossover trial.. J Pain Symptom Manage 2010; 39: 831-838 DOI: 10.1016/j.jpainsymman.2009.09.024.
    CrossrefPubMedGoogle Scholar
  • 11 Abernethy AP, McDonald CF, Frith PA. et al Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial.. Lancet 2010; 376: 784-793 DOI: 10.1016/S0140-6736(10)61115-4.
    CrossrefPubMedGoogle Scholar
  • 12 Bausewein C, Booth S, Gysels M. et al Non-pharmacological interventions for breathlessness in advanced stages of malignant and nonmalignant diseases.. Cochrane Database Syst Rev 2008; 02: CD005623 DOI: 10.1002/14651858.CD005623.pub3.
    CrossrefPubMedGoogle Scholar
  • 13 Fearon K, Strasser F, Anker SD. et al Definition and classification of cancer cachexia: an international consensus.. Lancet Oncol 2011; 12: 489-495 DOI: 10.1016/S1470-2045(10)70218-7.
    CrossrefPubMedGoogle Scholar
  • 14 Martin L, Senesse P, Gioulbasanis I. et al Diagnostic criteria for the classification of cancer-associated weight loss.. J Clin Oncol 2015; 33: 90-99 DOI: 10.1200/JCO.2014.56.1894.
    CrossrefPubMedGoogle Scholar
  • 15 Lundholm K, Gelin J, Hyltander A. et al Anti-inflammatory treatment may prolong survival in undernourished patients with metastatic solid tumors.. Cancer Res 1994; 54: 5602-5606
    PubMedGoogle Scholar
  • 16 Brisbois TD, Kock IH de, Watanabe SM. et al Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: results of a randomized, double-blind, placebo-controlled pilot trial.. Ann Oncol 2011; 22: 2086-2093 DOI: 10.1093/annonc/mdq727.
    CrossrefPubMedGoogle Scholar
  • 17 Strasser F, Luftner D, Possinger K. et al Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group.. J Clin Oncol 2006; 24: 3394-3400
    CrossrefPubMedGoogle Scholar
  • 18 Currow D, Temel JS, Abernethy A. et al ROMANA 3: A phase 3 safety extension study of anamorelin in advanced non-small cell lung cancer (NSCLC) patients with cachexia.. Ann Oncol 2017; 28: 1949-1956 DOI: 10.1093/annonc/mdx192.
    CrossrefPubMedGoogle Scholar
  • 19 Yennurajalingam S, Frisbee-Hume S, Palmer JL. et al Reduction of cancer-related fatigue with dexamethasone: a double-blind, randomized, placebo-controlled trial in patients with advanced cancer.. J Clin Oncol 2013; 31: 3076-3082 DOI: 10.1200/JCO.2012.44.4661.
    CrossrefPubMedGoogle Scholar
  • 20 Paulsen O, Klepstad P, Rosland JH. et al Efficacy of methylprednisolone on pain, fatigue, and appetite loss in patients with advanced cancer using opioids: a randomized, placebo-controlled, double-blind trial.. J Clin Oncol 2014; 32: 3221-3228 DOI: 10.1200/JCO.2013.54.3926.
    CrossrefPubMedGoogle Scholar
  • 21 White PD, Goldsmith KA, Johnson AL. et al Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial.. Lancet 2011; 377: 823-836 DOI: 10.1016/S0140-6736(11)60096-2.
    CrossrefPubMedGoogle Scholar
  • 22 Molassiotis A, Bailey C, Caress A. et al Interventions for cough in cancer.. Cochrane Database Syst Rev 2015; 05: CD007881 DOI: 10.1002/14651858.CD007881.pub3.
    CrossrefPubMedGoogle Scholar
  • 23 Razzak R, Waldfogel JM, Doberman DJ. et al Gabapentin for Cough in Cancer.. J Pain Palliat Care Pharmacother 2017; 31: 195-197 DOI: 10.1080/15360288.2017.1420120.
    CrossrefPubMedGoogle Scholar
  • 24 Smith JA, Harle A, Dockry R. et al Aprepitant for Cough in Lung Cancer. A Randomized Placebo-controlled Trial and Mechanistic Insights.. Am J Respir Crit Care Med 2021; 203: 737-745 DOI: 10.1164/rccm.202006-2359OC.
    CrossrefPubMedGoogle Scholar
  • 25 Thakerar A, Simadri K, Alexander M. et al Paroxetine for the treatment of intractable and persistent cough in patients diagnosed with cancer.. J Oncol Pharm Pract 2020; 26: 803-808 DOI: 10.1177/1078155219870594.
    CrossrefPubMedGoogle Scholar
  • 26 McGarvey LP, Birring SS, Morice AH. et al Efficacy and safety of gefapixant, a P2X(3) receptor antagonist, in refractory chronic cough and unexplained chronic cough (COUGH-1 and COUGH-2): results from two double-blind, randomised, parallel-group, placebo-controlled, phase 3 trials.. Lancet 2022; 399: 909-923 DOI: 10.1016/S0140-6736(21)02348-5.
    CrossrefPubMedGoogle Scholar
  • 27 Hetzel J, Bockeler M. Endoscopic treatment for tumorous obstructions of the tracheobronchial system: a comparison of available techniques.. Pneumologie 2012; 66: 408-415 DOI: 10.1055/s-0031-1291647.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 Wilson LD, Detterbeck FC, Yahalom J. Clinical practice. Superior vena cava syndrome with malignant causes.. N Engl J Med 2007; 356: 1862-1869 DOI: 10.1056/NEJMcp067190.
    CrossrefPubMedGoogle Scholar
  • 29 Cao S, Zou Y, Lyu T. et al Safety and Efficacy of Stent Graft Implantation for Malignant Superior Vena Cava Syndrome.. Heart Surg Forum 2021; 24: E952-E957 DOI: 10.1532/hsf.4129.
    CrossrefPubMedGoogle Scholar
  • 30 Wu Y, Li Y, Wang M. et al Percutaneous Endovascular Stent Placement for Treatment of Malignant Superior Vena Cava Syndrome: A Retrospective Review.. Ann Vasc Surg 2022; 80: 325-332 DOI: 10.1016/j.avsg.2021.10.025.
    CrossrefPubMedGoogle Scholar
  • 31 Bhatnagar R, Piotrowska HEG, Laskawiec-Szkonter M. et al Effect of Thoracoscopic Talc Poudrage vs Talc Slurry via Chest Tube on Pleurodesis Failure Rate Among Patients With Malignant Pleural Effusions: A Randomized Clinical Trial.. JAMA 2020; 323: 60-69 DOI: 10.1001/jama.2019.19997.
    CrossrefPubMedGoogle Scholar
  • 32 Olden AM, Holloway R. Treatment of malignant pleural effusion: PleuRx catheter or talc pleurodesis? A cost-effectiveness analysis.. J Palliat Med 2010; 13: 59-65 DOI: 10.1089/jpm.2009.0220.
    CrossrefPubMedGoogle Scholar
  • 33 Heigener D. Systemtherapie des NSCLC bei schlechtem Allgemeinzustand.. Info Pneumologie und Allergologie 2022; 02: 8-11
    Google Scholar