Palliative care and psychosocial care in metastatic non-small cell lung cancer: factors affecting utilisation of services and impact on patient survival

Duggan, Kirsten J; Wiltshire, Jennifer; Strutt, Rebecca; Boxer, Miriam M; Berthelsen, Angela; Descallar, Joseph; Vinod, Shalini

doi:10.1007/s00520-018-4379-7

Cited by 13 publications

(18 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 6-month, 1-year, and 2-year overall survival rates of the 102 patients with metastatic NSCLC were 17.65%, 3.92%, and 0.98%, respectively. The median overall survival of the 102 patients was 3.15 months ( Figure 2), which was consistent with that in previous studies, which reported a median overall survival of 3-5 months (24)(25)(26). These results provide greatly important basic survival data to researchers evaluating new treatment strategies for patients with recurrent stage III/IV NSCLC who show progression on multiple conventional treatments.…”

Section: Overall Survival Analysis Of All Patients With Advanced Stagsupporting

confidence: 89%

Association of tumor mutation burden and epidermal growth factor receptor inhibitor history with survival in patients with metastatic stage III/IV non-small-cell lung cancer: A retrospective study

Lan¹,

Zhou²,

Feng³

et al. 2021

Clinics

View full text Add to dashboard Cite

Lung cancer is the leading cause of cancer-related deaths worldwide. However, factors associated with the survival of patients with advanced non-small-cell lung cancer (NSCLC) who received only hospice care are largely unclear. In this study, we aimed to determine the prognostic factors correlated with survival in patients with advanced NSCLC who had undergone hospice care only. METHODS: A total of 102 patients with recurrent stage III/IV NSCLC after traditional treatment failure were investigated. Survival was measured from the date of enrollment to December 2019 or the time of death. Tumor tissues were collected, and DNA sequencing was performed to identify somatic mutations. Data on clinical factors of patients were collected and analyzed by univariate and multivariate analyses. Overall survival analysis was conducted using the Kaplan-Meier method. RESULTS: The 6-month, 1-year, and 2-year overall survival rates of the 102 patients with metastatic NSCLC were 17.65%, 3.92%, and 0.98%, respectively. The median overall survival of the 102 patients was 3.15 months. Tumor location in the peripheral lung, epidermal growth factor receptor (EGFR) inhibitor history, low tumor mutation load, adenocarcinoma, and poor performance status score were associated with prolonged survival compared with tumor location in the central lung, no EGFR inhibitor history, high tumor mutation load, squamous cell carcinoma, and good performance status score (p=0.045, p=0.003, p=0.045, p=0.021, and p=0.0003, respectively). CONCLUSIONS: EGFR inhibitor treatment history and tumor mutation load are risk factors for the overall survival of patients with stage III/IV NSCLC who have undergone only hospice care. These results provide a critical clinical basis for further study of nontraditional anti-tumor responses induced by EGFR inhibitors.

show abstract

Section: Overall Survival Analysis Of All Patients With Advanced Stagsupporting

confidence: 89%

Association of tumor mutation burden and epidermal growth factor receptor inhibitor history with survival in patients with metastatic stage III/IV non-small-cell lung cancer: A retrospective study

Lan¹,

Zhou²,

Feng³

et al. 2021

Clinics

View full text Add to dashboard Cite

show abstract

“…When discussing the implementation of palliative care, the advanced cancer population is often treated as a single entity. [3][4][5][6] However, as treatment for cancer advances and the life expectancy of many patients with advanced cancer increases, the needs of these patients should not be assumed homogenous. Our data clearly demonstrate a unique population of patients with severe disease who died within 6 months of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…healthcare that focuses on optimal management of pain and other symptoms while incorporating psychosocial and spiritual care according to patient/family needs, values, beliefs and cultures.'' 1 This philosophy has been implemented in a variety of ways in oncology practices around the world [2][3][4][5][6][7][8][9][10][11][12][13][14] and has been shown to improve patient outcomes, including decreased symptom severity, improved quality of life, and in some cases, decreased utilization of emergency department (ED) and hospital admissions. [15][16][17] The study by Temel et al (2010) showed improvement in quality of life, and notably increased survival in patients with advanced lung cancer when palliative care was introduced early in the course of illness.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Support Service, Emergency Department, and Hospital Utilization in Patients with Advanced Cancer: A Descriptive Study

et al. 2019

View full text Add to dashboard Cite

Context: Palliative care in oncology provides multiple benefits, however access to specialty palliative clinicians is limited in community cancer centers. Individual support services are more often available, but little is known on the utilization and impact of these services. Objectives: To describe the utilization of outpatient support services in the advanced cancer population and the association with ED and hospital use in a community setting. Methods: A retrospective chart review of 314 patients with advanced cancer of lung, gastrointestinal, genitourinary, and gynecologic origin was conducted. Data collected included demographics, descriptive data, type and number of support services (symptom management, nurse navigator, social worker, nutrition, financial counselor, chaplain, and oncology clinical counselor) within 90 days of diagnosis and descriptions of ED visits/hospitalizations within 12 months of diagnosis. Support services were available to patients by referral. Results: 29.6% of patients were deceased within 6 months and were considered to have severe disease. Patients with severe disease had a significantly greater mean number of support services than patients with non-severe disease (8.9 vs 6.0, p=0.001) and had a greater mean number of visits per year to the ED (6.4 vs 1.8, p<0.001). A greater proportion of patients with severe disease had palliative consultations (48.9% vs 21.7%, p<0.001), but 65.5% of palliative consultations occurred after an ED or hospital visit. Conclusion: Our data demonstrated that advanced cancer patients with severe disease had increased healthcare utilization in all areas measured. Despite high utilization, outpatient support services used in a reactive manner were not effective in reducing ED or hospital visits.

show abstract

“…Performance status, serum lactate dehydrogenase, C-reactive protein, presence of liver/adrenal gland metastases, and extrathoracic disease status significantly predicted survival and formed the basis of the score. Early palliative and supportive care rather than palliative radiotherapy may also be appropriate for patients with many adverse prognostic features [16]. Depending on prognosis, the goal of treatment, target volume size, and lung dose, the authors continue to prescribe 10 or 13 fractions of 3 Gy or, together with Carboplatin/Vinorelbine, 15 fractions of 2.8 Gy.…”

Section: Discussionmentioning

confidence: 99%

Early High-Grade Thoracic Toxicity After Palliative Radiotherapy for Non-Small Cell Lung Cancer

Nieder¹,

Imingen²

2021

Cureus

View full text Add to dashboard Cite

Introduction: Palliative radiotherapy or chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC) may cause thoracic toxicities due to the radiation dose delivered to the lungs, heart, and esophagus. We studied severe thoracic toxicities resulting in hospitalization or death during the acute and sub-acute phase, i.e., three months from commencing radiotherapy. In addition, risk factors were identified. Methods: A retrospective review of 165 patients treated with three-dimensional conformal palliative radiotherapy or CRT was performed. The prescribed total dose was equivalent to at least 30 Gy in 10 fractions. Uni- and multivariate analyses were employed. Results: Twelve patients (7%) were hospitalized within three months from the start of radiotherapy or CRT. Six patients were hospitalized for esophagitis, three for dyspnea most likely caused by pneumonitis, and three for cardiac arrhythmia. Fatal toxicity was not observed. However, 19% of the 165 patients died from tumor-related causes during the time period of interest. In multivariate analysis, the only esophageal dose was significantly associated with the risk of hospitalization. Conclusion: The safety profile of palliative radiotherapy or CRT in the acute and subacute phases was satisfactory. The hospitalization rate can be reduced by lowering the esophageal dose, as long as safe lung and heart doses can be maintained.

show abstract

Palliative care and psychosocial care in metastatic non-small cell lung cancer: factors affecting utilisation of services and impact on patient survival

Cited by 13 publications

References 19 publications

Association of tumor mutation burden and epidermal growth factor receptor inhibitor history with survival in patients with metastatic stage III/IV non-small-cell lung cancer: A retrospective study

Association of tumor mutation burden and epidermal growth factor receptor inhibitor history with survival in patients with metastatic stage III/IV non-small-cell lung cancer: A retrospective study

Patterns of Support Service, Emergency Department, and Hospital Utilization in Patients with Advanced Cancer: A Descriptive Study

Early High-Grade Thoracic Toxicity After Palliative Radiotherapy for Non-Small Cell Lung Cancer

Contact Info

Product

Resources

About