Early palliative care for patients with metastatic non-small-cell lung cancer.

@article{Temel2010EarlyPC,
  title={Early palliative care for patients with metastatic non-small-cell lung cancer.},
  author={Jennifer S. Temel and Joseph A Greer and Alona Muzikansky and Emily R. Gallagher and Sonal Admane and Vicki Ann Jackson and Constance Dahlin and Craig D. Blinderman and Juliet C. Jacobsen and William F. Pirl and Joanna Billings and Thomas J. Lynch},
  journal={The New England journal of medicine},
  year={2010},
  volume={363 8},
  pages={
          733-42
        }
}
BACKGROUND Patients with metastatic non-small-cell lung cancer have a substantial symptom burden and may receive aggressive care at the end of life. [] Key MethodMETHODS We randomly assigned patients with newly diagnosed metastatic non-small-cell lung cancer to receive either early palliative care integrated with standard oncologic care or standard oncologic care alone.

Figures and Tables from this paper

Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer.

  • J. GreerW. Pirl J. Temel
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2012
Although patients with metastatic NSCLC received similar numbers of chemotherapy regimens in the sample, early palliative care optimized the timing of final chemotherapy administration and transition to hospice services, key measures of quality end-of-life care.

Early palliative care and metastatic non-small cell lung cancer

A model of how early integrated palliative care could potentially influence survival in patients with advanced cancer is presented and shown to provide benefits in QOL, mood, and health care utilization.

Effects of Early Integrated Palliative Care in Patients With Lung and GI Cancer: A Randomized Clinical Trial.

  • J. TemelJ. Greer D. Ryan
  • Medicine, Psychology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2017
For patients with newly diagnosed incurable cancers, early integrated PC improved quality of life and other salient outcomes, with differential effects by cancer type.

Early Palliative Care in Patients With Non–Small-Cell Lung Cancer: A Randomized Controlled Trial in Southwest China

Among patients with non–small-cell lung cancer, early palliative care led to significant improvements in quality of life, psychological state and nutritional status.

Integrating Palliative Care Into the Care of Patients With Advanced Lung Cancer

The role of supportive and palliative care integrated into the treatment of patients with a diagnosis of advanced lung cancer is described with sections focused on the evaluation and treatment of pain and dyspnea, approaches to challenging communication tasks, and the support of caregivers who care for patients withAdvanced lung cancer.

Multisite, Randomized Trial of Early Integrated Palliative and Oncology Care in Patients with Advanced Lung and Gastrointestinal Cancer: Alliance A221303.

This study highlights the difficulties of conducting multicenter trials of supportive care interventions in patients with advanced cancer and confirms the benefits of early palliative care seen in prior single-center studies.

Depression and survival in metastatic non-small-cell lung cancer: effects of early palliative care.

  • W. PirlJ. Greer J. Temel
  • Medicine, Psychology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2012
The data do not support the hypothesis that treatment of depression mediated the observed survival benefit from early palliative care, and depression predicted worse survival in patients with newly diagnosed metastatic NSCLC.

Cost Analysis of a Randomized Trial of Early Palliative Care in Patients with Metastatic Nonsmall-Cell Lung Cancer.

The delivery of early PC does not appear to increase overall medical care expenses for patients with metastatic NSCLC, and larger, sufficiently powered cost studies of earlyPC are needed.

Early Contact with Palliative Care Services: A Randomized Trial in Patients with Newly Detected Incurable Metastatic Cancer

The study did not demonstrate a QoL benefit for early contact with a PC nurse, and there were non-significant trends for the place of death of early contact PC patients to be other than in an acute hospital, and for greater PC input during their final acute hospital admission.

Palliative Systemic Therapy Given near the End of Life for Metastatic Non-Small Cell Lung Cancer

In this retrospective cohort of patients with metastatic NSCLC, 22% of patients received SACT within 30 days of death, with a negative impact on access to PC, higher rates of in hospital death, decreased use of MAiD and palliative sedation, and a shorter median OS.
...

References

SHOWING 1-10 OF 47 REFERENCES

Phase II study: integrated palliative care in newly diagnosed advanced non-small-cell lung cancer patients.

  • J. TemelV. Jackson T. Lynch
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2007
Integrated palliative and oncology care is feasible in ambulatory patients with advanced NSCLC because 64% of patients completed at least 50% of their scheduled visits and QOL assessments.

Components of early intervention outpatient palliative care consultation in patients with incurable NSCLC.

  • V. JacksonJ. Jacobsen J. Temel
  • Medicine, Psychology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2009
Initial palliative care consultation near the time of diagnosis in patients with incurable NSCLC is lengthy and comprised primarily of symptom management, patient and family coping, and illness understanding and education.

Assessment of quality of life in the supportive care setting of the big lung trial in non-small-cell lung cancer.

  • J. BrownH. Thorpe M. Peake
  • Medicine, Psychology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2005
There was no evidence of a large detrimental effect on QoL of chemotherapy in the supportive care group, and there was a small but significant survival benefit in patients treated with chemotherapy compared with supportive care alone.

Chemotherapy versus supportive care in advanced non-small cell lung cancer: improved survival without detriment to quality of life

The survival benefit seen in this trial was entirely consistent with the NSCLC meta-analysis and subsequent similarly designed large trials, and the regimens used proved to be cost effective, the extra cost of chemotherapy being offset by longer survival.

Symptom frequency and severity in patients with metastatic or locally recurrent lung cancer: a prospective study using the Lung Cancer Symptom Scale in a community hospital.

Patients with advanced lung cancer suffer frequent and severe symptoms that worsen in the final months of life, and the appropriate timing and combination of radiotherapy and chemotherapy are yet to be resolved.

Symptoms at presentation for treatment in patients with lung cancer: implications for the evaluation of palliative treatment. The Medical Research Council (MRC) Lung Cancer Working Party.

Account must be taken of all symptoms at presentation, in addition to the traditionally recognised chest symptoms, in order to assess fully the benefit of palliative treatments in patients with lung cancer.

Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial.

Those receiving a nurse-led, palliative care-focused intervention addressing physical, psychosocial, and care coordination provided concurrently with oncology care had higher scores for quality of life and mood, but did not have improvements in symptom intensity scores or reduced days in the hospital or ICU or emergency department visits.

Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials

The results of this meta-analysis suggest that chemotherapy may have a role in treating non-small cell lung cancer, and reached conventional levels of significance when used with radical radiotherapy and with supportive care.

Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study.

Pretreatment global QoL and IADL scores, but not ADL and comorbidity, have significant prognostic value for survival of elderly patients with advanced non-small-cell lung cancer who were treated with chemotherapy.

Quality of life supersedes the classic prognosticators for long-term survival in locally advanced non-small-cell lung cancer: an analysis of RTOG 9801.

  • B. MovsasJ. Moughan D. Bruner
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2009
B baseline global QOL score replaced known prognostic factors as the sole predictor of long-term OS for patients with locally advanced NSCLC.