Linfangite carcinomatosa: impacto da terapêutica paliativa na qualidade de vida e prognóstico / Neoplastic pulmonary lymphangitis (NPL) is the intrapulmonary spread of metastatic neoplasm via lymphatic tissue, and accounts for 6-8% of lung metastasis: symptom distress has great impact on quality of life

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Our objective was to evaluate clinical aspects, treatment, QoL, and survival, in NPL in a prospective study. Median follow-up was of 32 days; 79% percent of patients were followed for less than 6 months, due to bad outcome. Median age was 60.5 years; 65% were female. Most primary tumor sites were lung and breast cancers (88%). QoL was compromised, but could have treatment benefit, especially with corticosteroids, and chemotherapy improved survival. Some variables were statistically significant for predicting survival status in one month, such as: Karnofsky performance scale (KPS)>=60%, hemoglobin>=10 g/dL, unilateral NPL, PO2>=60 mmHg, oncological systemic treatment, and no need for noninvasive assisted ventilation. Significant predictors of longer median survival were: KPS>=60%, SpO2>=90%, hemoglobin>=10 g/dL, without hypoxemia (PO2>=60 mmHg), no need for oxygen therapy, weak opioid treatment, systemic oncological treatment, and absence of assisted ventilation. Symptomatic treatment must be active, offering better QoL to patients and their families, and etiological treatment is important. QoL evaluation facilitates patient-physician relationship, and prognostic information is crucial to help in defining treatment plan, since cost-benefit parameter analysis and realistic goals are essential in good-quality palliative cancer care, especially for syndromes with poor prognosis, such as NPL.

ASSUNTO(S)

lymphangitis prognóstico lung qualidade de vida câncer palliative care cancer quality of life cuidado paliativo prognosis pulmão linfangite

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