Handbook of Supportive and Palliative Radiation Oncology

Handbook of Supportive and Palliative Radiation Oncology serves as a practical tool and rapid reference to assist radiation oncology practitioners in direct patient care with common palliative care issues. Containing the most recent advances in translational palliative care research, each chapter is organized in a succinct fashion to discuss major symptom burdens, suggested assessment, and various management options. Each symptom and disease section is written to be a rapid, practical guide for clinicians on the floor.

The book starts with general approaches in palliative radiation oncology that are followed by a section that focuses on common symptoms in palliative care and their management. The next section of the book is devoted to site and disease-specific evaluation, intervention, and management.

This handbook provides general guidelines and management recommendations for common clinical vignettes encountered by palliative radiation oncology practitioners and supported by palliative radiation oncology research. Concise references are cited to support treatment recommendation.

• Provides a quick reference for the busy clinician
• Details standard of care resources for researchers of palliative and supportive care
• Contains updated standards of care for palliative medicine and a list of common medications and dosages
• Includes a comprehensive index by symptom and condition to facilitate quick reference

Radiation oncologists, clinical oncologists, oncology researchers in supportive and palliative care, and cancer researchers interested in end-of-life standard of care

• 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