Table of Contents

Cover image

Title page

Copyright

List of Contributors

Preface

Acknowledgments

Part I: Issues in Supportive and Palliative Radiation Oncology

Chapter 1. General Approach to Palliative Care and Palliative Radiation Oncology

Abstract

Introduction

Life Expectancy and Prognostication

Religion and Spirituality

Relief of Pain and Suffering

Palliative Radiation Therapy

Efficacy of Palliative Radiation Therapy

Emerging Technologies

Radiation Therapy Planning and Delivery

Side Effects of Radiation Therapy

Guidelines and Quality Measures

Conclusion

List of Abbreviations

References

Chapter 2. Communication

Abstract

Introduction

ASK-TELL-ASK

Delivering Bad News: SPIKES

Responding With Empathy: NURSE

Discussing Prognosis: ADAPT

Conducting a Family Meeting/Goals of Care Discussion

FICA Spiritual History Tool

References

Chapter 3. Prognostication in Patients Receiving Palliative Radiation Therapy

Abstract

Introduction

Physician Accuracy

What Patients Want to Hear

Prognostic Factors

Prognostic Models

Future Directions

References

Chapter 4. Palliative Care, Hospice Care, Advance Care Planning, and Advance Directives

Abstract

Background

Palliative Care

Hospice

Advance Care Planning and Advance Directives

References

Chapter 5. Palliative Care Assessment

Abstract

Introduction

References

Part II: Symptom Management for Palliative Radiation Oncology Practitioners

Chapter 6. Pain Management

Abstract

Introduction

What Is Pain?

Common Pain Terminology

Pain Assessment

Patient Reported Outcomes

Management of Pain

Patient Case 1.1

Patient Case 1.2

Patient Case 1.3

Patient Case 1.4

Patient Case 1.5

Patient Case 1.6

Patient Case 1.7

Conclusion

Glossary

List of Abbreviations

References

Chapter 7. GI Symptoms: Radiation-Induced Adverse Effects

Abstract

Radiation-Induced Mucositis and Esophagitis

Radiation-Induced Diarrhea

Radiation-Induced Constipation

Radiation-Induced Nausea and Vomiting

References

Chapter 8. Management of Dyspnea and Central Airway Obstruction in Patients With Malignancy

Abstract

Introduction

Pathophysiology of Dyspnea

Evaluation of Dyspnea

Management of Potentially Reversible Etiologies of Dyspnea

Symptom Management for Dyspnea

Summary

Palliative Management of Malignant Central Airway Obstruction (CAO)

Summary

References

Chapter 9. Malignant Bleeding

Abstract

Scope of the Problem

Goals of Care, Communication, and Assessment

Local Therapies

Treatment Options by Site of Hemorrhage

Systemic Therapies and Considerations

Conclusion

References

Chapter 10. Skin Toxicity in Palliative Radiation Therapy

Abstract

Introduction

Acute Skin Toxicities From Radiation

Chronic Skin toxicities From Radiation

Radiation Recall Dermatitis

Conclusion

References

Part III: Disease-Specific Management for Palliative Radiation Oncology Practitioners

Chapter 11. Palliative Radiotherapy for Brain Metastasis

Abstract

Introduction

Palliative Radiotherapy Regimens

Evaluation and Management of Common Clinical Concerns

Conclusion

List of Abbreviations

References

Chapter 12. Palliative Radiotherapy for Malignant Epidural Spinal Cord Compression

Abstract

Introduction

Definition

Presentation

Prognostic Factors

Evaluation

Management

Recurrence

Summary

References

Chapter 13. Palliative Radiotherapy for Bone Metastasis

Abstract

Introduction/Background

Pathophysiology

Presentation/Evaluation

Clinical Assessment

Imaging

Management Overview

External Beam Radiation Therapy

Randomized Controlled Trials

Recommendations

Exceptions

Side Effects

QOL Improvement and Palliative EBRT

Re-Irradiation

Stereotactic Body Radiotherapy/Stereotactic Radiosurgery

External Beam Radiation Therapy Techniques

Radiopharmaceuticals for Diffuse Painful Bone Metastases

Beta Emitters

Summary

Alpha Emitters

Bisphosphonates and Denosumab to Prevent SREs

Bisphosphonates in Combination With EBRT

Denosumab

Conclusion

References

Chapter 14. Site-Specific Symptom Management: Palliative Radiotherapy for Advanced and Metastatic Lung Cancer

Abstract

Introduction

Evaluation

Treatment Recommendations

Expected Acute Side Effects

On-Treatment Management

References

Chapter 15. Palliative Radiation Oncology for Gastrointestinal Tract Malignancies

Abstract

Introduction/Background

Esophageal Cancer

Gastric Cancer

Pancreatic Cancer

Hepatobiliary Cancer

Anorectal Cancer

On Treatment Management

Conclusion

List of Abbreviations

References

Chapter 16. Palliative Radiotherapy for Advanced and Metastatic Gynecologic and Genitourinary Malignancies

Abstract

Introduction

Evaluation

Treatment Recommendations

Conclusion

List of Abbreviations

References

Chapter 17. Palliative Radiotherapy for Advanced and Metastatic Head and Neck Cancers and Skin Metastases

Abstract

Evaluation

Symptoms

Treatment Recommendation

Expected Acute Side Effects From Radiation

On Treatment Management

References

Index

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