Поздний лучевой сакроилеит крестцово-подвздошного сочленения через 20 лет после комплексного лечения рака тела матки (клинический случай)

Efficacy of Enzalutamide plus Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer by Pattern of Metastatic Spread: ARCHES Post Hoc Analyses.

What's New in Musculoskeletal Tumor Surgery.

Patterns of Recurrence and the Role of Radiation Therapy in Ovarian Clear Cell Adenocarcinoma

Experts' agreement on therapy for bone metastases

Chapter 61 - Role of radiation therapy in patients with bone metastasis

CORR Insights®: Which Bone-Modifying Agent is Associated with Better Outcomes in Patients with Metastatic Bone Disease from Lung Cancer? A Systematic Review and Network Meta-Analysis.

EDITORIAL article Front. Oncol., 15 August 2023Sec. Surgical Oncology Volume 13 - 2023 | https://doi.org/10.3389/fonc.2023.1247231

The use of music therapy in pain and symptom management in the care of patients with long-term and life-threatening illnesses can be an effective non-pharmacologic approach to help ameliorate pain and suffering. By altering affective, cognitive, and sensory processes, music may decrease pain perception by distraction, change in mood, increased control, use of prior skills, and relaxation. This article reviews the background of the use of music therapy in pain management, explores a theoretical framework, and describes methods and techniques. Three case studies are provided to demonstrate the work.

Pain Response After Stereotactic Body Radiation Therapy Versus Conventional Radiation Therapy in Patients With Bone Metastases—A Phase 2, Randomized Controlled Trial Within a Prospective Cohort

Quality of life in prostate cancer patients.

To the Editor: The worldwide pandemic of Coronavirus Disease (COVID-19) has dramatically and rapidly spread in Italy the last month. By now, nevertheless Italian government efforts to contain the outbreak with escalating restrictive measures, 205,463 cases were confirmed, with 27,967 deaths (http://www.salute.gov.it/portale/nuovocoronavirus/). Cancer patients are potentially more susceptible to Coronavirus infection with a greater need for intensive support than healthy population since their immune system is often compromised. Bone metastases are a common complication of advanced cancer that can cause severe and debilitating effects including severe pain, reduced mobility, spinal cord compression, life-threatening electrolyte imbalances and pathologic fracture (Lutz et al., 2011). Stepwise treatment options consist in pain medication (opioids and nonsteroidal anti-inflammatory drugs, or NSAIDs), systemic therapy (bone modifying agents, i.e. bisphosphonates such as pamidronate or zoledronic acid and denosumab), chemotherapy and/or hormone therapy (dependent on the primary cancer), radiation therapy (external beam radiation therapy (EBRT), stereotactic body radiation therapy and radiopharmaceuticals) and/or surgery (Gralow et al., 2009). Palliative radiotherapy is a well-accepted treatment for painful uncomplicated bone metastases and provides significant palliation in around 70% of patients, with up to 10%–35% of patients achieving complete pain relief at the treated site (Chow et al., 2001). Moreover, EBRT prevents impending fractures inducing remineralization for strengthening of destabilized bone. It also promotes healing of pathological fractures reducing the skeletal-related events and leading to a better quality of life (McDonald et al., 2014). In an unprecedented situation such as the ongoing pandemic of Coronavirus disease, the choice of the best treatment for bone metastases must be weighted in a careful way in order to avoid as much as possible the risk of contagion for cancer patients. To guarantee the best care and reduce the impact of COVID-1 on these patients, the use of pain medication (both opioid and nonopioid analgesics such as NSAIDs) should be the first option and EBRT should be used only if “unavoidable”, in patients for whom the first treatment strategy is ineffective. Radiotherapy for bone metastases is historically delivered using hypofractionated schedules. Several randomized control trials (RCTs) asserted that both single fraction radiation therapy (SFRT) and multiple fraction radiation therapy (MFRT) are efficacious in providing pain relief caused by uncomplicated bone metastases (Janjan et al., 2009), although MFRT may be more effective for patients with complicated metastases, neuropathic pain or spinal cord compression. For patients with spinal cord compression but with a poor survival prognosis, a single fraction of 8 Gy seems to be as effective for functional outcome as multifractionated regimens (Rades et al., 2005). Given the equal effectiveness of the various schedules, decisions regarding fractionation for bone metastases may be tailored based on overall clinical conditions and life expectancy evaluated using appropriate prognostic scores, and costs. For instance, for patients whose life expectancy is less than 3 months, short-course palliative radiotherapy (such as 8 Gy in one fraction) can provide effective palliation while minimizing multiple treatment visits (Gripp et al., 2010). Therefore in order to minimize the exposure of patients with bone metastases to COVID-19 without compromising oncological outcome, the choice of the short-course palliative radiotherapy with 8 Gy in one fraction sounds to be the most reasonable. In fact this schedule has the advantage to reduce the length of patients’ exposure to hospital environment during radiotherapy and, as a consequence, to the risk of contagion. In all cases the risks and benefits of radiotherapy treatment must be discussed with patients to allow shared decision making and it is primary to guarantee a safe treatment adopting adequate screening and preventive measures for the patients and staff. The radiation treatment room and nearby areas should be sanitized during treatment intervals and protective measures should be provided to patients and radiotherapy technicians. The time patients spend in the waiting room should be minimized encouraging them not to arrive early or allowing them to wait outside the hospital and texting them when their appointment is ready to begin (Wei et al., 2020). Moreover dedicated path for cancer patients separated from other hospital patients should be assured. Therefore, as National Institute for Health and Care Excellence recommends, “use radiotherapy only if unavoidable” (Mahase, 2020); for patients with painful bone metastases refractory to pain medication or with spinal cord compression the use of single fraction radiotherapy instead of more prolonged RT schedules is safer and more reasonable. For oligometastatic or oligoprogressive patients, and only if a safe treatment with adequate preventive measures can be offered, a very short course of stereotactic radiotherapy can be hypothesized and not deferred in order to provide a better local control rate and longer duration of symptom palliation. None.

To investigate the clinical features and prognosis of bone metastases in colorectal cancer patients. The clinical data of 104 cases of colorectal cancer with bone metastasis were collected and retrospectively analyzed. Among all the 104 patients included, 45 (43.3%) patients had multiple bone metastases, and 59 (56.7%) patients had single bone metastasis. Pelvis (46.1%) was the most common site, followed by thoracic vertebrae (41.3%), lumbar vertebrae (40.4%), sacral vertebrae (29.8%) and ribs (29.8%). One hundred and two patients (98.1%) were complicated with other organ metastases. The median time from colorectal cancer diagnosis to bone metastasis was 16 months, and the median time from bone metastasis to first skeletal-related events (SREs) was 1 month. The most common skeletal-related events (SREs) were the need for radiotherapy (44.2%), severe bone pain (15.4%) and pathologic fracture (9.6%). The median survival time of patients with bone metastases was 10.0 months, and 8.5 months for patients with SREs. ECOG score, systemic chemotherapy and bisphosphonate therapy were prognostic factors by univariate analysis (all P < 0.05). ECOG score and systemic chemotherapy were independent prognostic factors by Cox multivariate analysis. Bone metastasis in colorectal cancer patients has a poor prognosis and the use of chemotherapy and bisphosphonates may have a benefit for their survival.

View/Download PDF Download ---Citations--- BibTeX RIS Buy Reprints PDF Translate this page into: English Arabic Chinese (Simplified) Dutch English French German Greek Hebrew Italian Japanese Korean Persian Portuguese Russian Spanish Turkish Urdu Abstracts 27 (3); 471-482 doi: 10.25259/IJPC_8_2021 PDF Download Citations BibTeXRIS Poster Presentation Umesh Bhadani​ Organizing Secretary, IAPCON 2021, India *Corresponding author: Umesh Bhadani, Organizing Secretary, IAPCON 2021, India. umeshbhadani@gmail.com Received: 2021-07-09, Accepted: 2021-07-09, Epub ahead of print: 2021-11-09, Published: 2021-11-24 © 2021 Published by Scientific Scholar on behalf of Indian Journal of Palliative Care Licence This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. PP-01 Attributes of psychosocial distress from the perspectives of head and neck cancer patients Shalini G. Nayak Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India E-mail: shalini.mcon@manipal.edu. Mobile: 9481375675 Background: Patients diagnosed with head and neck cancer (HNC) face unique challenges in comparison to other types of cancers. Sources of psychosocial distress are multifactorial and recognising key attributes would facilitate better understanding of the experienced distress, potentially enabling directed intervention strategies. Objective: The current research was conducted with the objective of exploring the key attributes of psychosocial distress from HNC patients perspective to develop a tool. Methods: The study adopted a qualitative approach. The data were collected from nine HNC patients receiving radiotherapy through focus group discussion. Data were transcribed, read and re-read through for searching the meanings and patterns, to familiarise with the data and obtain ideas on experiences related to psychosocial distress. Similar experiences identified across the dataset were sorted and then collated into themes. Detailed analysis of themes and related quotes of the participants are reported with each theme. Results: The codes generated from the study are grouped under four major themes; some symptoms are distressing, Distressing physical disability inflicted by the situation, Social Curiosity- a distressing element, and Distressing uncertainty of future. The attributes of psychosocial distress and magnitude of psychosocial problems were reflected from the findings. Conclusion: Psychosocial health of the HNC patient is greatly impacted due to disease and/or treatment. Dynamic patterns of attributes identified from the study contributed in developing a tool on psychosocial distress. Findings of this study also necessitate the need for constructing an intervention for psychosocial distress based on the attributes from the HNC patients perspective. PP-02 Role of radiation therapy in mammary analogue secretary carcinoma of salivary gland Prince Kumar Department of Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India E-mail: Reticent123@gmail.com. Mobile: 9655466031 Introduction: Recently recognised entity previously diagnosed as Zymogen granule poor Acinic cell Carcinoma Shows morphologic and molecular features similar to the secretory carcinomas of the breast occurs in men and women in both major and minor salivary glands IHC-Positive for S100, MUC4 and Mammaglobin (very specific) specific, novel chromosomal translocation ETV6-NRTK3 fusion gene. t (12; 15) (p13; q25). Case Report: A 45-year-old gentleman presented with a complaint of painless swelling over the right parotid gland swelling was insidious in onset and progressive on examination - 4 x 4 cm, nodular, mobile and nontender swelling found in Right Parotid region. Facial nerve was NOT involved FNAC-Mammary Analogue Secretory Carcinoma Superficial Parotidectomy was performed: Tumour was grey-white in colour, lobular, measuring 2.8 x 1.4 x 0.8 cm and breaching the capsule. He received adjuvant radiation 66Gy/33 fractions with Volumetric Arc Radiation Therapy (VMAT). During course of treatment no significant acute reactions was observed. Discussion: MASC is a newly recognised malignant salivary gland tumour that recapitulates the histology and genetics of SC of the breast reported cases of MASC encompass a broad range of clinical behaviours, from indolent to aggressive. The mean disease-free survival being 92 months (Chiosa et at.). It has high incidence of local recurrence and lymph node metastasis than Acinic cell carcinoma, longer follow-up is warranted (Chiosea et at.) standard of care for low-grade malignant salivary gland tumours is radical surgical resection. Post-operative radiation is reserved for close (<5 mm) margins/incomplete resection, perineural invasion. PP-03 Spirituality in the golden years Bhoopathy Baptist Hospital, Bengaluru, Karnataka, India E-mail: naidums2003@gmail.com. Mobile: 9845797006 Aim: Spiritual care should be inclusive part of geriatric standard care. Background: Patients with terminal disease and in pain are looking for answers like why me. Hence, there is a dire need for spirituality in their life so that they can gain self-knowledge about themselves and life. Development of a spiritual culture among patients, their families and community will go a long way in helping patients. Methods: 15 elderly patients selected randomly and orally questioned about (1) need for longevity of life, (2) aspiration to live with family, (3) need for more medical benefits, (4) need for more counselling and (5) importance to die gracefully and peacefully. Results: About 80% said no to living long at any cost. About 50% do not want to stay with family and would prefer old age community centre with good facilities. About 70% said government and hospitals need to do more for them. About 80% feel government existing are sufficient, but need better implementation. About 90% feel private healthcare is costly and this stresses them. Discussion and Conclusion: Elderly care culture should be imbibed by youngster in schools. Importance of spirituality should be taught in all stages of life. Awareness of importance of spirituality in overall elderly care in the hospital and among doctors, nursing staff should be developed in a systemic fashion. It should be standardised and protocol driven including regular assessment of cognition, social and emotional assessment and specifically tailored counselling and other support systems. Approaching death with grace is spirituality. PP-04 Golden butterflies magic envelop: An innovative art and recreational package during COVID-19 Ramalakshmi Golden Butterflies Children’s Palliative Care Foundation, Chennai, Tamil Nadu, India E-mail: ramviyenar95@gmail.com. Mobile: 6380660206. Background and Aim: Golden butterflies (GB) provides counselling and arts-based therapy for child-patients and their families; finance for nutrition, tests and treatment; a home away from home; and conducts trainings and awareness programs on palliative care and counselling, in Chennai. GB magic envelope was initiated in response to the COVID-19 pandemic, when group sessions of art and recreational therapy with as child-patients was no longer possible. Magic Envelope is an A4 envelope that includes a small therapeutic craft activity, a puzzle, colouring/drawing sheets and a gift “all age appropriate. All raw materials required to do the craft activity are enclosed, along with child-friendly illustrations/pictorial instructions/cues. Assembling of these edutainment kits is done by GB volunteers, guided by an art-based therapist. As a pilot, magic envelopes were couriered to six child-patients at their residences. This study was conducted to evaluate the effect of engaging with GB magic envelopes on child-patients and their caregivers. Methods: Telephonic interviews using a structured questionnaire were conducted with 6 caregivers of child-patients, who had been consistently receiving magic envelopes for 6 months. Results: GB magic envelope was found to have kept the child-patient engaged, alleviated their boredom during the pandemic and stimulated their creative talents. Observing the child-patient creatively occupied was de-stressing for their caregivers. Interestingly, siblings of the child-patients also evinced interest in completing the activities. Conclusion: Magic Envelope edutainment kits can be used as a safe alternative to face-to-face group sessions with child-patients. PP-05 Introducing a psychosocial care pathway for a comfortable dying at home T. J. Jose Babu Alpha Palliative Care, Thrissur, Kerala, India E-mail: drjosebabu@gmail.com. Mobile: 9074342844 Background and Aims: Ensuring a good death is one of the aims of palliative care. Pain and symptom management alone is not sufficient to add life to their days. This pilot study among advanced cancer patients by implementing a novel care pathway developed by Team Alpha aims to improve the quality of dying and death. Methodology: Thirty advanced cancer patients were included in this pilot study. Home based interventions such as life review, communication using a question prompt list, discussions on unfinished businesses, living will, legacy projects and vigil plan (which constitutes the care pathway) were done serially by a trained social worker. Bereavement visits were done to take feedback and death review was conducted by the palliative care team. Results: The interventions such as life review and discussions using question prompt list were carried out on all the participants (100%). About 96% of participants responded to questions on unfinished businesses and also on living will. About 75% of the participants responded positively to the discussion on Legacy projects. About 88% of participants responded to Vigil plan. Discussion and Conclusion: The Life review step had a positive impact and the participants were relieved a lot after venting out. Questions on unfinished business helped them to set priorities. The advance directives were documented. Patients have been inspired to write messages to their kids, to be cherished even after death. Vigil plan discussed about the arrangements at the last hours. This ‘care pathway’ improves the quality of dying and death experience among advanced cancer patients as per bereavement feedback and needs further study. PP-06 Psilocybin and medical cannabis in palliative care using real world evidence R. Praveenlal Fellow in Palliative Medicine E-mail: praveenlalravi@gmail.com. Mobile: 9447382516 Background: Cancer patients often develop a chronic psychosocial distress having depressed mood, anxiety and reduced quality of life, up to 40% of cancer patients meeting criteria for a mood disorder. Psilocybin and medical cannabis tend to have promising effects on management of cancer related distresses. Aim: The aim of the study was to bring Psilocybin and medical cannabis as an integral part of palliative medicine using real world evidence to enhance quality of life and empathy. Methodology: Randomised article search in various data bases including Science Direct, Scopus, Google Scholar, PubMed and EMBASE using bullion terminologies. Results: Majority preferred CBM over placebo for cancer/therapy related symptom management. In most cases, no serious adverse events were attributed to THC: CBD. High dose psilocybin produced large decrease in depressed mood and anxiety with increase in QOL, life meaning and optimism and decrease in death anxiety. Six month follow-up these changes were sustained with 80% of participants. Conclusion: Historically safe profile of cannabis could make data from other clinical trial more admissible to formulate reliable clinical practice guidelines. Single dose psilocybin produces substantial and enduring decrease in depressed mood and anxiety with increase in QOL. Reference: RR Griffith et al. Psilocybin produces substantial decreases in depression and anxiety in patients with life-threatening cancer: Journal of psychopharmacology vol 30, 2016. Carhart Harris et al.: Neural correlates of psychedelic states determined by fMRI studies with psilocybin; PNAS, Feb 7 2012 Vol 109. Cannabis in palliative care: ANN Palliat med 2018. PP-07 Multidisciplinary team involvement to overcome body image distress in a palliative care patient with facial edema A case study Srushti Hiremath Consultant Physiotherapist E-mail: srushti.hiremath@ciplacare.com. Mobile: 9561681438 Introduction: Facial oedema is common and distressing symptom among patients who have undergone head and neck surgery/radiation therapy. Up to 75% of patient’s manifest facial oedema and approximately 77% patients have body image distress in head/neck cancer. Case: A 51-year-old male patient diagnosed with Ca right retro molar trigone area and operated for right hemi mandibulectomy with the right radical neck dissection with flap, presented to us with severe facial oedema, non-healing wound at right submandibular region and sever pain at wound site which was aggravated on facial/neck movements. He had difficulty in eye opening, expressing his emotions through facial expressions and overall communication was hampered. We noticed him observing his own face in the mirror frequently. He was embarrassed about his looks, drooling from his mouth and didn’t wish to meet anyone. His body image distress caused frustration, anxiety, anger and irritability. Discussion: Aggressive pain management led to reduction in pain. Patient became more open for communication and suggestions. Nursing care of wound with dressing and bandaging reduced odour and oosing. Physiotherapy was started which resulted in drastic reduction in facial oedema. Psychosocial interventions were carried which helped patient to express and cope with body image. This resulted in reduction in anxiety and frustration. He was encouraged to communicate and express his feelings in written format. Thus, the entire team came together to target this complex distress of the patient. Patient cantered goals helped him to overcome his distress and smile on his face was truly satisfying for us as team. PP-08 Palliative care in elderly Covid-19 patients Aditya Kumar Chauhan Government Medical College, Haldwani, Uttarakhand, India E-mail: adidon27@gmail.com. Mobile: 9410349997 Background: While the whole population is at risk from infection with the COVID-19, elderly people with comorbidities are at higher risk for severity and fatality. These patients whose outcome are not certain and have end of life situation calls for good palliative care. Aims: The aim of the study was to provide good palliative care including supportive care and pharmacological treatment symptomatically. Methods: A group of 71 patients were taken, age >65 years and all recommended pharmacological measures according to patient condition were adapted with psychological therapy. Results: A total of 71 patients were taken which were all severely ill and provided with timely therapeutic approach and psychosocial support to reduce the suffering and outcome. Out of which 38 patients improved and 33 patients expired. Conclusion: Elderly patients are particularly susceptible to adverse clinical outcomes in COVID-19 pandemic. Both pharmacological methods and psychosocial support improve the outcome even in severely ill cases of elderly patients. PP-9 Effect of palliative radiotherapy on malignant fungating wound of breast cancer Deepika Sharma DNB Resident E-mail: 1991.deepika30@gmail.com. Mobile: 9671674290 Background and Aims: Incurable malignant fungating ulcer in breast cancer patients invariably suffer from general symptoms such as breast pain, bleeding, ulceration and discharge, malodour and thus require palliative radiotherapy. Hypofractionated RT has many advantages in palliative settings, but very few studies on incurable malignant wound have been conducted. This study will be conducted to see effects of hypofractionated RT on symptomatic patients. Methods: Twenty patients with incurable malignant fungating ulcer underwent hypofractionated palliative RT were retrospectively analysed. RT was performed at a total dose of 20gy in 5 fractions with 4Gy per fraction. The treatment effects were evaluated with respect to symptom improvement, tumour response and treatment related toxicity. Results: The main symptoms that the patients complained of before RT were pain, bleeding and discharge, malodour and fungating wound. Rest of the results to be elaborated in poster presentation. Discussion and Conclusion: Hypofractionated radiotherapy could safely and effectively relieve symptoms among incurable malignant fungating wound in breast cancer patients. PP-10 An interesting case of rheumatological bone disorder mimicking metastatic bone tumour Prajakta Dilip Bhagat Tata Memorial Centre, Mumbai, Maharashtra, India E-mail: paarijaat90@gmail.com. Mobile: 9004549363 Introduction: Malignancy and autoimmune disorders can present with diagnostic complexities. Patients presenting with any unusual bump and lump in the bone can often be mistaken for malignancy. Case Description: A 40-year-old Muslim lady presented to oncology OPD with the right ankle swelling for 1 year, biopsy confirmed the presence of osteoid producing malignant tumour consistent with osteosarcoma, CECT chest showed symmetrical pattern of involvement with some calcified areas suggestive of ?metastasis. Patient was advised palliative amputation which she did not consent to. She was referred to Palliative Medicine unit for further symptom management. On evaluation patient had severe left shoulder pain and movement restriction. MRI shoulder showed bulky left subscapularis muscle, fluid collection with synovial thickening in subacromial and subdeltoid bursae, with fluid within the biceps few and on MRI was Patient was evaluated for any autoimmune disorder an was to any patient is under evaluation to there is an other systemic condition mimicking the Discussion: and rheumatological disorders should be from malignancy. not diagnosed can in pain, patient’s quality of life, and up to psychological We have high of for and autoimmune the and COVID-19 response with body care Hospital, E-mail: Mobile: Introduction: like take for of their During in response to the COVID-19 pandemic were in Palliative Care team in small sessions using adapted by Medical to on in COVID-19 and were and follow-up poster and were to participants. The to a by team safe care a was with participants 6 after the Methods: An structured questionnaire Google of questions exploring was to all participants 4 after the Results: participants responded to the found this very and for their work and the was very and for 40% were very and with the About 70% said using and was new and for The was very new for the 80% to safely care for a Discussion and Conclusion: This and follow-up to develop new on safely using and COVID-19 and feel to care for in their of intervention in palliative care E-mail: Mobile: Background: Social from families to with effect of most palliative care patients are home based care to Palliative care patients are on such as and which have significant and need to be patient with and is of A an in counselling, and of Objective: We to the of from to and by patients and the of intervention in terms of counselling, to Data analysis of of patients. of clinical outcomes determined by team which of patients by of and interventions Results: for patients, out of which patients were on interventions to in current of and by the in to the clinical team could bring Conclusion: intervention in of medicine counselling in palliative home care patients will to intervention by clinical team and reduction in overall medicine management. pilot during COVID-19 pandemic Hospital, E-mail: Mobile: Background and Aims: The disease pandemic has impacted to healthcare in due to improve healthcare and provide psychosocial support to patients and caregivers in the stages of the pandemic, a pilot for palliative care patients and caregivers within of was conducted. Methods: 15 patients and caregivers were over the by trained healthcare in using a structured identified were to medical health was provided and were referred to care and government for Results: About patients and caregivers were of the symptoms of 40% patients and caregivers were about disease About patients and caregivers were who to for About patients and caregivers had and/or serious about of patients and caregivers reported and in the patients and 88% caregivers were about their to and patients and all caregivers reported having to from when their emotional Discussion and Conclusion: Patients with palliative care needs are among who are to the of is a way to increase COVID-19 awareness and and improve to healthcare and among these patients. of life and health in caregivers of patients with cancer in palliative DNB Resident E-mail: Mobile: Background: Cancer with has from being in the in most patients often being a chronic disease palliative treatment. In the palliative caregivers who provide care to severely ill patients an and of care This to as as positive effects on health and quality of life The situation the due to for care over medical and with emotional which to and objective cost. research has been done on health and quality of life of caregivers to patients at home with advanced cancer. This study anxiety, depression and in of patients with cancer in the palliative Aim: The aim of this study was to anxiety, depression and in of patients with metastatic cancer in the palliative for at home with and data Patients and Methods: The of of patients receiving palliative treatment for various cancers. was with the Medical and health with the hospital anxiety and depression The were with data the outcome of the (1) of both higher of anxiety and depression and of than (2) In both and anxiety and are with the patients and their need for care in life activities. The outcome will be elaborated in the Conclusion: We an health and in many to and The effect of palliative radiotherapy in bone T. DNB Resident E-mail: Mobile: Background and Aim: an of malignant in surgical and in the systemic management of patients with metastatic disease a for the radiation The of the radiation therapy is to provide pain and the quality of life. The aim of the study is to the effect of radiotherapy response to in bone with various The of patients with of various tumours who received palliative radiation of in 5 fractions with 4Gy per at Cancer and were retrospectively analysed. The treatment effect was evaluated with response to pain by the on Palliative Results: This study would the treatment response on in 5 fractions which would be elaborated in poster presentation. Conclusion: have pain for including in in 6 in 5 fractions and a fraction. This is to the effect of in 5 which is being at The importance of in the hospital standard care culture Bhoopathy Baptist Hospital, Bengaluru, Karnataka, India E-mail: naidums2003@gmail.com. Mobile: 9845797006 Aim: The aim of the study was to build culture and in the hospital and palliative Objective: The objective of the study was to as medical tool to medical and medical staff in Background: Baptist emotional and they are in medical social social as as such as and social and work in to the patient through the medical care. and Methods: and patients, orally questioned about the benefits, about and Results: About 90% in care in ill patients. About 70% of and are with empathy. About 80%

External Beam Radiation Therapy for Palliation of Symptomatic Bone Metastases: An ASTRO Clinical Practice Guideline

Should bisphosphonates be used routinely in patients with prostate cancer metastatic to bone?