Early palliative care for metastatic NSLC
Trial question
What is the effect of early palliative care in patients with metastatic non-small cell lung cancer?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
52.0% female
48.0% male
N = 151
151 patients (78 female, 73 male).
Inclusion criteria: patients with newly diagnosed metastatic non-small cell lung cancer, within 8 weeks after diagnosis.
Key exclusion criteria: patients already receiving care from palliative care service, ECOG performance status > 2, and not able to read and respond to questions in English.
Interventions
N=77 early palliative care (early palliative care integrated with standard oncologic care).
N=74 standard oncologic care (no routine early palliative care).
Primary outcome
FACT-L quality of life scores at 12 weeks
98 points
91.5 points
98.0 points
73.5 points
49.0 points
24.5 points
0.0 points
Early palliative
care
Standard oncologic
care
Significant
increase ▲
Significant increase in FACT-L QoL scores at 12 weeks (98 points vs. 91.5 points; MD 6.5, 95% CI 0.5 to 12.4).
Secondary outcomes
Significant decrease in depression at 12 weeks, as assessed by Hospital Anxiety and Depression Scale (16% vs. 38%; RR 0.42, 95% CI 0.1 to 0.74).
Significant increase in median survival (11.6 vs. 8.9; MD 2.7, 95% CI 0.42 to 4.98).
Conclusion
In patients with newly diagnosed metastatic non-small cell lung cancer, within 8 weeks after diagnosis, early palliative care was superior to standard oncologic care with respect to a FACT-L QoL scores at 12 weeks.
Reference
Jennifer S Temel, Joseph A Greer, Alona Muzikansky et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010 Aug 19;363(8):733-42.
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