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목적 : 종양 환자들은 다수에서 치명적인 예후를 갖 음에도 불구하고 그들의 사망에 대한 관심과 보고는 적 다. 그러므로 저자들은 말기암 환자를 대상으로 주요 증 상과 치료 및 사망 원인에 대하여 조사하여 적절한 치료 와 관리를 하는데 필요한 기초 자료로 구축하고자 본 연 구를 시행하였다. 방법 : 1999년 1월부터 2001년 12월까지 부산대학교 병원 혈액 종양내과에 입원한 말기암 환자 중 고식적를 받고 사망한 73명의 환자를 대상으로 하였고, 기저 악성 질환, 사망 전 주요 임상 증상 및 치료, 직접 사인에 대 하여 후향적 방법으로 조사하였다. 결과 : 총 73명의 환자가 포함되었고, 평균 연령은 53 세(19 78세)였다. 기저 악성 질환은 고형종양 45명 (62%), 급성 골수성 백혈병 9명(12%), 비호지킨 림프종 8명(11%), 만성 골수성 백혈병 7명(10%), 다발성 골수종 4명(5%)이었다. 환자들의 주요 임상 증상은 마약성 진 - 69 - - Korean Journal of Medicine : Vol. 65, No. 1, 2003 - 통제가 필요한 통증, 호흡곤란(WHO grade ≥2), 중추신 경계 증상, 발열, 출혈, 황달, 난치성 구토, 점막염이었다. 마약성 진통제, 수혈, 항생제가 주요 치료법이었으며 호 흡기계 감염이 가장 중요한 직접사인이었다.


Background : Although most patients with cancer have a fatal outcome, it seems that the concern and study may be not enough. This study was aimed to perform the analysis of the cause of death, main symptom and treatment of the patients with terminal cancer and to provide the basic information about their adequate management. Methods : We reviewed the medical records of 73 terminal cancer patients who had been managed with palliative therapy and died at Pusan National University Hospital from January 1999 to December 2001. The underlying malignant disease, ante-mortem symptoms, therapy and immediate cause of deaths were studied. Results : A total 73 terminal cancer patients was included. The mean age was 53 years. Underlying malignant diseases were solid tumor (62%), acute myeloid leukemia (12%), non-Hodgkin's lymphoma (11%), chronic myeloid leukemia (10%), multiple myeloma (5%). The solid tumor was composed of gastrointestinal tract cancer (38%), head & neck cancer (13%), cancer of unknown primary site (9%), lung cancer (11%), hepatobiliary tract cancer (7%), cervical cancer (7%), ovarian cancer (4%), malignant melanoma (4%), soft tissue sarcoma & osteosarcoma (4%) and brain tumor (2%). The frequencies of the clinical complaints evaluated were the pain necessitating opiates, dyspnea (WHO grade ≥2), CNS disturbances, fever, hemorrhage, jaundice and intractable vomiting. Opiates, transfusions and antibiotics were the main therapy and pneumonia were the most important immediate causes of death. Conclusion : This results could be used as the basic information for the patients with terminal cancer and suggests a need for multi-center cooperation study.(Korean J Med 65:66-70, 2003)


Background : Although most patients with cancer have a fatal outcome, it seems that the concern and study may be not enough. This study was aimed to perform the analysis of the cause of death, main symptom and treatment of the patients with terminal cancer and to provide the basic information about their adequate management. Methods : We reviewed the medical records of 73 terminal cancer patients who had been managed with palliative therapy and died at Pusan National University Hospital from January 1999 to December 2001. The underlying malignant disease, ante-mortem symptoms, therapy and immediate cause of deaths were studied. Results : A total 73 terminal cancer patients was included. The mean age was 53 years. Underlying malignant diseases were solid tumor (62%), acute myeloid leukemia (12%), non-Hodgkin's lymphoma (11%), chronic myeloid leukemia (10%), multiple myeloma (5%). The solid tumor was composed of gastrointestinal tract cancer (38%), head & neck cancer (13%), cancer of unknown primary site (9%), lung cancer (11%), hepatobiliary tract cancer (7%), cervical cancer (7%), ovarian cancer (4%), malignant melanoma (4%), soft tissue sarcoma & osteosarcoma (4%) and brain tumor (2%). The frequencies of the clinical complaints evaluated were the pain necessitating opiates, dyspnea (WHO grade ≥2), CNS disturbances, fever, hemorrhage, jaundice and intractable vomiting. Opiates, transfusions and antibiotics were the main therapy and pneumonia were the most important immediate causes of death. Conclusion : This results could be used as the basic information for the patients with terminal cancer and suggests a need for multi-center cooperation study.(Korean J Med 65:66-70, 2003)