1.High-Grade, Advanced Tongue Cancer Treated with Arterial Injection Chemoradiotherapy by Multidisciplinary Medical Teams
Akio YASUI ; Shoichiro KITAJIMA ; Hisanobu MARUO ; Harumi MIZUTANI ; Emi SAWAKI ; Mariko MIZOGUCHI ; Yuna KATO ; Shinichi ISHIKAWA ; Masayo SOBUE ; Akiko UNESOKO ; Keiko NAITO ; Masaki NAKATA ; Hayato SIGEMURA ; Mayu MATSUOKA ; Tomoko NODA ; Tetsuya ANDO ; Minoru TERASAWA
Journal of the Japanese Association of Rural Medicine 2016;65(1):83-92
In recent years, favorable therapeutic outcomes have been reported for arterial injection chemoradiotherapy for tongue cancer. The present case involves an 80-year-old woman in our palliative care department who had high-grade, advanced tongue cancer. Because there was a request for surgery to prevent airway occlusion due to growth of the tumor, she was referred to our department in April 2009. As a treatment policy for controlling tumor growth in high-grade, advanced tongue cancer, arterial injection chemoradiotherapy was carried out through the superficial temporal artery, with a tongue artery catheter in place on both sides. Therapeutic effect was obtained, and it was possible to avoid airway occlusion through tumor regression. Dysphagia and dysphemia were improved, which in turn improved quality of life. In this case, there was an opportunity to carry out multidisciplinary team medicine, including support from the oral care and palliative care teams as part of the process of cancer therapy. Here, we present our findings in this case.
2.Factors Related to Gemcitabine-induced Phlebitis
Akiko UNESOKO ; Akio KOHNO ; Nobukazu TOMITA ; Kiyoshi ISHIGURE ; Ayumi SUGIMURA ; Kazuki SATO ; Shoko ANDO
Palliative Care Research 2018;13(2):187-193
Objective: The purpose of this study was to clarify the factors related to gemcitabine (GEM)-induced phlebitis. Methods: We retrospectively analyzed 400 cases of intravenous GEM administration to 50 patients from June 2014 to May 2015. We assessed the relationship between GEM-induced phlebitis and various factors including age, sex, BMI, analgesic use (NSAIDs or opioids), and GEM-administration procedures including drug formulation, dosage, and access site. Results: Phlebitis occurred in 79 cases (19.8%). Multivariate analysis indicated that sex (female), age (<65 years old), BMI (≥25 kg/m2; obesity), drug formulation (liquid), and access site (dorsal hand vein) were significantly related to the presence of phlebitis. Discussion: GEM-administration procedures should be modified in patients with these risk factors. It is desirable to apply hot fomentation and to puncture at the brachial region or cubital fossae region vein to prevent phlebitis.
3.End-of-life Care and Good Death of Dying Non-cancer Patients from the Perspective of Bereaved Family Members
Akiko UNESOKO ; Kazuki SATO ; Yuka ONISHI ; Mitsunori MIYASHITA ; Tatsuya MORITA ; Masahiro IWABUCHI ; Yuna GOTO ; Hiroya KINOSHITA
Palliative Care Research 2019;14(3):177-185
Objectives: To assess the perception of care and outcomes of end-of-life palliative care by bereaved family members to determine differences in care provided to patients with and without cancer. Methods: This cross-sectional, anonymous survey using a self-reporting questionnaire for bereaved family members was conducted online. Care was assessed using overall satisfaction score and the care evaluation scale (CES) and outcomes were assessed using good death inventory (GDI). Results: The present study included data from 118 patients with cancer and 299 patients without cancer (103, heart failure; 71, stroke; and 125, pneumonia). The overall satisfaction score was not significantly different between patients with and without cancer. Conversely, physical care score in the CES and autonomy score in the GDI were significantly lower in patients without cancer than in patients with cancer (p<0.05). Conclusion: The satisfaction with end-of-life care was comparable between the bereaved family members of patients without cancer and those of patients with cancer. However, results related to some items of CES and GDI suggest that some components of end-of-life care for patients without cancer might require attention. Not only treatment of the underlying disease but also relief of suffering is important to improve end-of-life care.