Impact of early palliative interventions on the outcomes of care for patients with non-small cell lung cancer

Nieder, Carsten; Tollåli, Terje; Haukland, Ellinor; Reigstad, Anne; Flatøy, Liv Randi; Engljähringer, Kirsten

doi:10.1007/s00520-016-3278-z

Cited by 38 publications

(38 citation statements)

References 23 publications

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“…Two other studies, both retrospective (which represents their main limit), evaluated OS [40, 41] that was better for the EPC group in both studies, and the difference was statistically significant.…”

Section: Resultsmentioning

confidence: 94%

“…Studies’ outcomes are summarized in Table 2. OS was better for EPC group in almost all studies that evaluated this endpoint [24, 40, 41], and the difference was always statistically significant; in addition, better OS in EPC group was often associated with less chemotherapy near the end of life. QoL was also almost always better for EPC group, and the difference was greater with the increase in average observation.…”

Section: Resultsmentioning

confidence: 98%

“…Aware of this potential limitation, authors opted for cluster randomization to maximize recruitment, and were able to attain their planned sample size. Probably in the intervention group, there were more ill patients, and this aspect could explain because there were more deaths in this group.Nieder et al [40](1) Retrospective trial. (2) Lack of standardized treatment protocol; the additional intervention was at the discretion of the treating physicians and timing was not standardized.…”

Section: Resultsmentioning

confidence: 99%

“…In the study by Nieder et al [40], EPC group was compared with late palliative care and with no palliative care. OS was significantly better for the EPC group, in particular: median survival was 14.0 months in patients who received additional early palliative care, 6.7 months in the late palliative care, and 7.7 months in the no palliative care groups ( p = 0.001, pooled over strata).…”

Section: Resultsmentioning

confidence: 99%

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Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Ambroggi

Biasini

Toscani

et al. 2018

Support Care Cancer

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PurposeMetastatic non-small-cell lung cancer (NSCLC), the leading cause of death from cancer worldwide, is a debilitating disease that results in a high burden of symptoms and poor quality of life; the estimated prognosis after the diagnosis has been established was less than 1 year until some years ago. At the present, the new targeted therapies and immunotherapy are changing the course of the disease. However, advanced NSCLC remains an incurable disease, with a poor prognosis for the majority of the affected patients, so that quality of life and relief from symptoms are primary objectives of treatment. Some evidences suggest that early palliative care (EPC) for these patients can improve quality of life and even survival.DesignA systematic review of the studies evaluating the impact on objective and on patient-reported outcomes of the introduction of EPC in opposition to standard care (SC), for advanced lung cancer patients, was performed. Because of the small number of studies conducted in this area, retrospective studies were also considered for the review.ResultsFive studies were included because they matched the inclusion criteria previously defined as relevant for the study. The review found that both survival and quality of life were better for patients included in EPC groups.ConclusionsWhile results of the studies included in this review are not always comparable because different methods and scales have been used, there is enough evidence for clinical oncologists to implement the use of EPC in clinical practice for advanced lung cancer patients.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Ambroggi

Biasini

Toscani

et al. 2018

Support Care Cancer

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“…WHO cancer care guidelines recommend that palliative care be involved as early as possible, specifically from the time of diagnosis 26. Two papers that explored timing defined ‘late’ palliative care involvement as <30 days24 and <90 days25 before death. Palliative care was consulted in the majority of MAiD requests (85%) captured by our study.…”

Section: Resultsmentioning

confidence: 99%

Situating requests for medical aid in dying within the broader context of end-of-life care: ethical considerations

2018

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BackgroundMedical aid in dying (MAiD) was introduced in Quebec in 2015. Quebec clinical guidelines recommend that MAiD be approached as a last resort when other care options are insufficient; however, the law sets no such requirement. To date, little is known about when and how requests for MAiD are situated in the broader context of decision-making in end-of-life care; the timing of MAiD raises potential ethical issues.MethodsA retrospective chart review of all MAiD requests between December 2015 and June 2017 at two Quebec hospitals and one long-term care centre was conducted to explore the relationship between routine end-of-life care practices and the timing of MAiD requests.ResultsOf 80 patients requesting MAiD, 54% (43) received the intervention. The median number of days between the request for MAiD and the patient’s death was 6 days. The majority of palliative care consults (32%) came less than 7 days prior to the MAiD request and in another 25% of cases occurred the day of or after MAiD was requested. 35% of patients had no level of intervention form, or it was documented as 1 or 2 (prolongation of life remains a priority) at the time of the MAiD request and 19% were receiving life-prolonging interventions.InterpretationWe highlight ethical considerations relating to the timing of MAiD requests within the broader context of end-of-life care. Whether or not MAiD is conceptualised as morally distinct from other end-of-life options is likely to influence clinicians’ approach to requests for MAiD as well as the ethical importance of our findings. We suggest that in the wake of the 2015 legislation, requests for MAiD have not always appeared to come after an exploration of other options as professional practice guidelines recommend.

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Timing of palliative care needs reporting and aggressiveness of care near the end of life in metastatic lung cancer: A national registry‐based study

Goldwasser

Vinant

Aubry

et al. 2018

Cancer

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Impact of early palliative interventions on the outcomes of care for patients with non-small cell lung cancer

Abstract: Early additional palliative care resulted in relevant improvements. The optimal timing of this intervention should be examined prospectively.

Cited by 38 publications

References 23 publications

Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Situating requests for medical aid in dying within the broader context of end-of-life care: ethical considerations

Timing of palliative care needs reporting and aggressiveness of care near the end of life in metastatic lung cancer: A national registry‐based study

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