Personalized Palliative and Survivorship Care for Patients With Metastatic Cancer Treated With Radiation Therapy

Abstract

While the benefits of early palliative care for patients with metastatic cancer are well established, cancer survivorship remains inadequately integrated into the care of patients with distant metastases. Moreover, the optimal model of care delivery is poorly defined. A prognostic model previously developed and validated at Good Samaritan University Hospital identified four groups of patients with metastatic solid tumor malignancy having very favorable, favorable, standard or unfavorable prognoses with median survival of 31, 14, 4 and 1 month, respectively. This framework holds promise for the personalized delivery of supportive, palliative and survivorship care services in the context of radiation therapy. We review the published literature providing the rationale for a novel multidisciplinary care model where the radiation oncology Clinical Nurse Specialist identifies and coordinates interventions to address unmet physical and emotional issues faced by survivors with metastatic cancer with the goal of improving quality of life and overall survival.

Thirty-day Mortality in Palliative Radiotherapy: A Retrospective Cohort Analysis in a Single Center

“…There is a pressing need for endeavors directed towards the improvement and precision of the criteria employed for determining the appropriate timing of radiotherapy initiation (10). Furthermore, when administering palliative radiotherapy, the implementation of a customized care framework guided by a multidisciplinary healthcare team becomes imperative for enhancing both survival rates and the overall quality of life for these patients (11).…”

Long-term disease-free survival following comprehensive involved site radiotherapy for oligometastases

“…While retrospective series are not typically associated with complete and deep record keeping, as a single physician series, these patients are extremely well known to the physician over a period of years (33). It seems likely that followup quality will be more complete than multi-institutional databases reflecting the experience of a large number of providers (34). Finally for this oncologist with extensive experience with treatment distant metastases, selection of curative intent comprehensive metastatic ablation was informed not only by technical feasibility but also by prognosis using a validated model to supplement clinical intuition (17,35).…”