Palliative Care Case Report: A Man with End Stage Lung Cancer with Brain Metastases

Authors

  • Yanuar Ardani Psychosomatic and Palliative Division, Department of Internal Medicine Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo National General Hospital Jakarta, Indonesia, Indonesia
  • Hamzah Shatri Psychosomatic and Palliative Division, Department of Internal Medicine Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo National General Hospital Jakarta, Indonesia, Indonesia
  • Rudi Putranto Psychosomatic and Palliative Division, Department of Internal Medicine Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo National General Hospital Jakarta, Indonesia, Indonesia
  • Rendi Faris Anggono Department of Internal Medicine Faculty of Medicine, University of Diponegoro/ Doctor Kariadi General Hospital Semarang, Indonesia, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v10i2.901

Keywords:

Brain Metastases, Lung Cancer, Palliative Care

Abstract

INTRODUCTION : Lung cancer accounts for 13% of malignancies in the world and the most common type of cancer suffered by men in Indonesia. The 5-year survival rate for patients with lung cancer is only 18.1%. About 25-30% will develop brain metastases. Overall palliative care is needed including biologically targeted therapy, chemotherapy, stereotactic radiosurgery (SRS), surgery in selected cases, and whole brain radiotherapy treatment (WBRT). Rare studies that take into account surgical palliation in advanced NSCLC. It has been demonstrated that metastaticectomy generally improves survival and, in some patients, even long-term survival.

CASE REPORT : A 65-year-old male patient with Non-Small Cell Carcinoma favor Lung Adenocarcinoma and cerebellum metastases. The patient underwent surgery to remove a brain tumor. The patient received 8 radiotherapies and Erlotinib chemotherapy for 4 cycles for 6 months. The dose of Erlotinib 150g/24 hours was used in the first month. The dose was reduced in the 2nd to 6th month to 100g/24 hours. Assessment of palliative care was carried out using the Karnopsky Questionnaire, Fatigue Severity Scale (FSS), and Palliative Performance Scale (PPS).

CONCLUSION : . Despite major improvements in the way lung cancer patients are treated in recent years, morbidity and death rates are still high. Palliative care (PC) is an approach to treating patients with life-threatening diseases, one of which is lung cancer

Downloads

Download data is not yet available.

References

1. Kementerian Kesehatan Republik Indonesia. Pedoman Pengendalian Faktor Risiko Kanker Paru. Direktorat Jenderal Pencegah dan Pengendali Penyakit. Published online 2018:29.
2. National Cancer Institute. Surveillance, Epidemiology, and End Results Program. Cancer stat facts: Lung and bronchus cancer. U.S. Department of Health and Human Services. Published 2022. Accessed December 3, 2022. https://seer.cancer.gov/statfacts/html/lungb.html.
3. Kementrian Kesehatan Republik Indonesia. Laporan Riskesdas 2018 Nasional.pdf. Published online 2019:674.
4. Mendoza TR, Kehl KL, Bamidele O, et al. Assessment of baseline symptom burden in treatment-naïve patients with lung cancer: an observational study. Support Care Cancer. 2019;27(9):3439-3447. doi:10.1007/s00520-018-4632-0
5. Iyer S, Roughley A, Rider A, Taylor-Stokes G. The symptom burden of non-small cell lung cancer in the USA: A real-world cross-sectional study. Support Care Cancer. 2014;22(1):181-187. doi:10.1007/s00520-013-1959-4
6. Yip Y-C, Yip K-H, Tsui W-K. Palliative Care for Patients with Lung Cancer: A Review of the Current Developments in the Field and Perspectives on the Implementation of Care. Support Palliat Care Cancer Patients [Working Title]. 2022;(November). doi:10.5772/intechopen.106797
7. Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM Classification for lung cancer. J Thorac Oncol. 2016;11(1):39-51. doi:10.1016/j.jtho.2015.09.009
8. Wao H, Mhaskar R, Kumar A, Miladinovic B, Djulbegovic B. Survival of patients with non-small cell lung cancer without treatment: a systematic review and meta-analysis. Syst Rev. 2013;2(1):10. doi:10.1186/2046-4053-2-10
9. Nichols L, Saunders R, Knollmann FD. Causes of death of patients with lung cancer. Arch Pathol Lab Med. 2012;136(12):1552-1557. doi:10.5858/arpa.2011-0521-OA
10. Lagerwaard F, Levendag P, Nowak PC., Eijkenboom W., Hanssens P., Schmitz P. Identification of prognostic factors in patients with brain metastases: a review of 1292 patients. Int J Radiat Oncol Biol Phys. 1999;43(4):795-803. doi:10.1016/S0360-3016(98)00442-8
11. Owen S, Souhami L. The management of brain metastases in non-small cell lung cancer. Front Oncol. 2014;4(SEP):1-6. doi:10.3389/fonc.2014.00248
12. Jamal-Hanjani M, Spicer J. Epidermal growth factor receptor tyrosine kinase inhibitors in the treatment of epidermal growth factor receptor-mutant non-small cell lung cancer metastatic to the brain. Clin Cancer Res. 2012;18(4):938-944. doi:10.1158/1078-0432.CCR-11-2529
13. Purba A, Wibisono B. Pola Klinis Kanker Paru Rsup Dr. Kariadi Semarang Periode Juli 2013 - Juli 2014. J Kedokt Diponegoro. 2015;4(4):389-398. http://ejournal-s1.undip.ac.id/index.php/medico%0AArdina
14. Yopi Andry Lesnussa. Model Matematika Kemoterapi Kanker Dan Simulasinya Dengan Software Matlab. J Kedokt. 2012;5(1):19-23.
15. Komite Penanggulangan Kanker Nasional. Panduan Penatalaksanaan Kanker Paru. Published online 2018:1-33.
16. Husen A. Hubungan Antara Derajat Nyeri Dengantingkat Kualitas Hidup Pasien Kanker Paruyang Menjalani Kemoterapi. Diponegoro Med J (Jurnal Kedokt Diponegoro). 2016;5(4):545-557.
17. Joseph J, Rotty LWA. Kanker Paru: Laporan Kasus. Med Scope J. 2020;2(1):17-25. doi:10.35790/msj.v2i1.31108
18. Ananda RR, Ermayanti S, Abdiana A. Hubungan Staging Kanker Paru dengan Skala Nyeri pada Pasien Kanker Paru yang Dirawat di Bagian Paru RSUP DR M Djamil Padang. J Kesehat Andalas. 2018;7(3):430. doi:10.25077/jka.v7i3.898
19. Baik CS, Chamberlain MC, Chow LQ. Targeted Therapy for Brain Metastases in EGFR-Mutated and ALK-Rearranged Non-Small-Cell Lung Cancer. J Thorac Oncol. 2015;10(9):1268-1278. doi:10.1097/JTO.0000000000000615
20. Luo D, Ye X, Hu Z, et al. EGFR mutation status and its impact on survival of Chinese non-small cell lung cancer patients with brain metastases. Tumor Biol. 2014;35(3):2437-2444. doi:10.1007/s13277-013-1323-9
21. Miles B, Mackey JD. Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors and Lung Cancer: History, Epidemiology, and Market Outlook. Cureus. 2021;13(2):0-4. doi:10.7759/cureus.13470
22. Srivastava H, Negi P, Kingsley PA, Sachdeva J. Management of lung cancer brain metastasis: An overview. Asian J Oncol. 2017;03(02):121-127. doi:10.4103/asjo.asjo_79_16
23. Gerber NK, Yamada Y, Rimner A, et al. Erlotinib versus radiation therapy for brain metastases in patients with  EGFR-mutant lung adenocarcinoma. Int J Radiat Oncol Biol Phys. 2014;89(2):322-329. doi:10.1016/j.ijrobp.2014.02.022
24. Zhou Y, Yu F, Zhao Y, et al. A narrative review of evolving roles of radiotherapy in advanced non-small cell lung cancer: From palliative care to active player. Transl Lung Cancer Res. 2020;9(6):2479-2493. doi:10.21037/tlcr-20-1145
25. Fitri EkY, Natosba J, Andhini D. Gambaran Pengetahuan, Sikap, dan Tindakan Perawatan Paliatif Perawat. Semin Work Nas. Published online 2017:218-222.
26. Ekowati FD. Gambaran Pengetahuan dan Sikap Perawat tentang Perawatan Paliatif Pada Pasien Kanker. Univ Muhammadiyah Surakarta. Published online 2021:19. http://eprints.ums.ac.id/id/eprint/91713

Additional Files

Published

2023-07-31

How to Cite

1.
Ardani Y, Shatri H, Putranto R, Anggono RF. Palliative Care Case Report: A Man with End Stage Lung Cancer with Brain Metastases. Medica Hospitalia J. Clin. Med. [Internet]. 2023 Jul. 31 [cited 2024 Dec. 22];10(2):245-50. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/901

Citation Check