Palliative Care for Bone and Soft Tissue Sarcoma Patients

ABSTRACT Background There have been few studies on palliative care for patients with bone and soft tissue sarcoma due to its low prevalence. We report 19 cases of patients with bone and soft tissue sarcoma who were consulted to the palliative care team. Method We retrospectively reviewed all medical records of patients with bone and sot tissue sarcoma who were hospitalized for chemotherapy and consulted to the palliative care team from January 2010 to 15 October 2011. Results Nineteen patients (6 males and 13 females) were reviewed in this study. The median age was 50 years (23–87). The histological subtypes included leiomyosarcoma (n = 8), gastrointestinal stromal tumor (n = 3), Ewing sarcoma (n = 2), angiosarcoma (n = 2), osteosarcoma (n = 1), chondrosarcoma (n = 1), synovial sarcoma (n = 1), and malignant fibrous sarcoma (n = 1). The sites of metastases were lung (n = 11), pelvic viscera (n = 8), liver (n = 7), and bone (n = 7). The median number of chemotherapy regimens was 2 (0–5). The most common life-threatening complication was respiratory failure (n = 6), followed by bleeding of the tumor (n = 3), pulmonary embolism (n = 2), and bowel perforation (n = 1). Reasons of consultation were psychological support (n = 7), intractable pain (n = 6), and lymphedema (n = 6). Fifteen patients (79%) used opioids, including fentanyl patch 33%, fentanyl continuous infusion 20%, oral oxycodone 20%, oral morphine 13%, and morphine continuous infusion 13%. One patient used an antidepressant drug. Conclusions The patients with bone and soft tissue sarcoma tended to be highly distressed by the absence of enough information about their disease and standard chemotherapy in the early stage of therapy, therefore they needed psychological support. In the middle and the late stage of disease, they tended to have life-threatening complications that worsen the prognosis.