Impact of interstitial pneumonia complications on palliative medication for terminal lung cancer: A single-center retrospective study |
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| Affiliation: | 1. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center 6-16-1 Tomioka-Higashi, Kanazawa-ku, Yokohama City, Kanagawa 236-0051, Japan;2. Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan;1. Department of Medicine, School of Medicine, Chiba University, Chiba 260-8670, Japan;2. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;3. Health Professional Development Center, Chiba University Hospital, Chiba 260-8670, Japan;4. Department of Pulmonary Medicine, School of Medicine, International University of Health and Welfare, Chiba 286-8686, Japan;5. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;6. Department of Pathology, Chiba University Hospital, Chiba 260-8670, Japan;7. Department of Hematology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-8677, Japan;8. Department of Hematology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;9. Department of Hematology, School of Medicine, International University of Health and Welfare, Chiba 286-8686, Japan;1. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan;2. Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan;3. Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan;1. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan;2. Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan;1. Pain Relief and Supportive Care Unit, La Maddalena Cancer Center, Palermo, Italy;2. Department of Biotechnological and Applied Clinical Sciences, University of L''Aquila, L''Aquila, Italy;3. Hospice and Home Care Program, FARO Foundation, Turin, Italy;4. Home Care Program, ASP 6, Genoa, Italy;5. “L''Aquila per la Vita” Home Care Unit, L''Aquila, Italy;6. Section of Clinical Epidemiology and Environmental Medicine, Department of Biotechnological and Applied Clinical Sciences, University of L''Aquila, L''Aquila, Italy;7. Division of Hematology, Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I, Home Care Service of the Rome Section of the Italian Association Against Leukemias (Rome AIL), Rome, Italy;8. Clinical and Molecular Medicine Department, Sapienza University, Sant''Andrea Hospital, Rome, Italy;9. Section of Anesthesia, Analgesia, Intensive Care and Emergency, Department of Biopathology, Medical and Forensic Biotechnologies, Policlinico “P. Giaccone”, University of Palermo, Palermo, Italy;10. Home Care Program, SAMO, Palermo, Italy;1. Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan;2. Department of Respiratory Medicine, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan;3. Department of Rehabilitation, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan |
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| Abstract: | BackgroundInterstitial pneumonia (IP) is associated with high comorbidity of lung cancer (LC). We aimed to investigate whether concomitant IP affects palliative pharmacotherapy for end-stage symptom relief in patients with LC.MethodsWe retrospectively examined the clinical records of LC patients who died in our hospital between 2015 and 2017. The patients were divided into the IP-LC (LC with comorbid IP) and LC (LC without IP) groups according to the presence of IP to compare the use of opioid and midazolam in their terminal period.ResultsIn total, 236 patients were enrolled in this study and divided into the IP-LC (n = 70) and LC (n = 166) groups. Among them, 51.2% and 65.7% patients in the LC and IP-LC groups, respectively, required continuous opioid administration to relieve dyspnea and/or pain. There were no significant between-group differences in the median initial and maximum doses and continuous opioid administration duration. The frequency of concomitant use of continuous midazolam and opioids was higher in the IP-LC group than in the LC group (20.5% vs. 7.1%; p = 0.01), primarily because of refractory dyspnea in all patients in both groups. The median survival time after the initiation of continuous opioid administration did not change irrespective of continuous midazolam administration.ConclusionsCompared with patients with LC, those with IP-LC are more likely to require continuous midazolam administration because continuously administered opioids alone are not sufficiently effective in relieving end-stage dyspnea among the latter. |
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| Keywords: | Interstitial pneumonia Lung cancer Opioid Midazolam Palliative sedation ILD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" interstitial lung disease IP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" interstitial pneumonia IPF" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" idiopathic pulmonary fibrosis LC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" lung cancer LTOT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" long-term oxygen therapy HFNC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0090" }," $$" :[{" #name" :" text" ," _" :" high-flow nasal cannula NPPV" },{" #name" :" keyword" ," $" :{" id" :" kwrd0100" }," $$" :[{" #name" :" text" ," _" :" noninvasive positive pressure ventilation arterial oxygen partial pressure to fractional inspired oxygen ratio QoL" },{" #name" :" keyword" ," $" :{" id" :" kwrd0120" }," $$" :[{" #name" :" text" ," _" :" quality of life oxygen saturation of peripheral artery to fraction of inspiratory oxygen ratio |
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