What Is Palliative Chemotherapy?

For patients with tumors that recur, metastasize, or cannot be resected at the time of surgery, chemotherapy is often used to shrink and stabilize the tumor for long-term maintenance. Chemotherapy at this time is called "palliative chemotherapy".

Palliative chemotherapy

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For recurrence, metastasis after surgery, or unresectable

In fact, it is difficult to uniformly specify the timing of "palliative chemotherapy" because such chemotherapy is performed in the "coexistence of human tumors". Modern treatment has also developed into a model of suppressing the rapid growth of tumors with chemotherapy and maintaining long-term stability with new drugs, in order to "fast use of drugs, slow use of drugs with slow drugs", complementary advantages, and complement each other to obtain the greatest antitumor effect and the smallest toxic side effects And the best quality of life. The purpose of palliative chemotherapy is not to completely destroy the tumor, but to be able to smoothly control the progress of the tumor, alleviate the pain of the patient, and extend its life.

1. Systemic Chemotherapy: It is administered intravenously, intramuscularly or orally, and the drug is distributed in various organs and tissues throughout the body.

2. Local Chemotherapy, including special routes of chemotherapy:

(1) Intracavitary chemotherapy: including intrathoracic chemotherapy, intrapericardial chemotherapy, and intraperitoneal chemotherapy, which can treat cancerous serositis and serous fluid.

(2) Intrathecal chemotherapy: Intrathecal administration through lumbar puncture allows anti-cancer drugs to enter the cerebrospinal fluid. It is often used to treat central nervous system leukemia or lymphoma, central nervous system primary tumors and other malignant tumors. .

(3) Interventional chemotherapy: high- or ultra-selected arterial or venous intubation and catheterization or puncture, infusion of large doses of anticancer drugs to increase local blood concentration and enhance the effect of chemotherapy. Such as hepatic artery intubation interventional chemotherapy (commonly used with embolism), or portal vein puncture interventional chemotherapy for primary or metastatic liver cancer.

(4) Intratumoral injection of drugs, that is, anti-cancer drugs are injected directly into the tumor. For example, direct injection of anhydrous alcohol or mitomycin into small liver cancer lesions is usually performed under the guidance of B ultrasound or CT.

(5) Bladder perfusion chemotherapy: It is mainly used for the treatment of bladder tumors and is administered through a urinary catheter. The commonly used drugs are mitomycin and doxorubicin and BCG vaccine.

In the clinical treatment of tumors, palliative treatment is advocated throughout the entire course of tumor treatment. The purpose of palliative treatment is to obtain the best quality of life for cancer patients, and it is a humane treatment concept. It is a continuous treatment for patients' psychological, social, mental problems and pain.

It must be affirmed that palliative treatment plays a vital role in the quality of life of patients with advanced cancer and prolongs the survival of patients, and palliative chemotherapy plays a very important role in it. Palliative chemotherapy for advanced colorectal cancer. The Colorectal Cancer Collaborative Group summarizes individual case data and statistics summarized by published clinical trials to determine whether the disease is advanced or metastatic. Pros and cons of palliative chemotherapy in cancer patients, and compare results with younger and older patients. Randomized controlled trials comparing palliative chemotherapy and supportive care in patients with advanced colorectal cancer were confirmed after conducting computer and manual literature and reference browsing or directly contacting researchers. Mainly compare the items of survival, disease progression, quality of life and toxicity analysis. A total of 1365 patients in 13 randomized controlled trials met the inclusion criteria. Seven of the trials (including 866 patients) that provided individual case data were pooled. The results show that palliative chemotherapy can reduce the risk of death by 35% (95% confidence interval is 24% -44%). This means that both the 6-month and 12-month survival rates increased by 16%, with a median survival of 317 months. Chemotherapy did not show age-related differences. Of all the data, the quality of the data related to treatment side effects, symptom control, and quality of life was too poor to perform relevant analyses. Chemotherapy is effective in delaying the progression of disease and prolonging the survival of patients with advanced colorectal cancer. Since some patients in the control group also received chemotherapy, the effect of chemotherapy on prolonged survival in this analysis may be underestimated.

The trace element selenium plays a role in resisting the side effects of radiotherapy and chemotherapy, and detoxifying and synergizing. l Selenium can enhance immunity. Organs such as lymph nodes, liver, and spleen are high in selenium, and these tissues are where the immune cells are concentrated. Therefore, selenium supplementation can effectively improve the immunity of patients undergoing chemoradiotherapy, enabling them to successfully complete chemoradiotherapy. l Selenium can reduce the toxicity of chemotherapy drugs. Studies have shown that taking large doses of selenium before and after chemotherapy can reduce side effects such as lowering of white blood cells, nausea, vomiting, loss of appetite, severe hair loss, and nephrotoxicity, which can help increase the dose of chemotherapeutics reasonably for better results. l Selenium can reduce the resistance of chemotherapy drugs. Long-term chemotherapy, malignant tumor cells are prone to drug resistance. The use of chemotherapeutic drugs and high-dose selenium supplementation can significantly reduce the resistance of malignant tumor cells to chemotherapeutic drugs, making them always sensitive to chemotherapeutic drugs and easy to treat. l Selenium can remove harmful free radicals. Selenium is a strong antioxidant. The human body can supplement selenium in large doses during radiotherapy, which can quickly improve the body's antioxidant capacity, remove harmful free radicals, and reduce side effects during radiotherapy. It should be noted that although selenium can have excellent resistance to the side effects of chemoradiotherapy. However, when selecting selenium supplements, care must be taken not to add large doses to avoid selenium poisoning.

There has been some controversy over the issue of chemotherapy in patients with advanced tumors, questioning whether chemotherapy can bring benefits. However, randomized controlled studies in most centers around the world over the past 10 years have proven that the former is superior to the latter in terms of recent efficiency, median survival, and quality of life compared with the best supportive care.

(1) Eat foods that are easy to digest / nutrient-rich.

(2) Eat less sweets and try to avoid greasy / fried foods.

(3) Small meals / multiple meals.

(4) For those who have nausea / severe vomiting / inability to eat, tell the medical staff that the doctor can arrange to give antiemetics 30 to 60 minutes before chemotherapy and 4 to 6 hours after chemotherapy.

(5) Pay attention to the amount of in and out, and report to the medical staff in a timely manner so that the doctor can infusion intravenously in time to avoid causing electrolyte disorders.