Impact of interstitial pneumonia complications on palliative medication for terminal lung cancer: A single-center retrospective study

Autor: Hiroko Okabayashi, Eri Hagiwara, Satoshi Ikeda, Akimasa Sekine, Tsuneyuki Oda, Hideya Kitamura, Tomohisa Baba, Takuro Sakagami, Takashi Ogura
Rok vydání: 2021
Předmět:
Zdroj: Respiratory Investigation. 59:859-864
ISSN: 2212-5345
Popis: Background Interstitial 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. Methods We 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. Results In 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. Conclusions Compared 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.
Databáze: OpenAIRE
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