Symptom Clusters in Patients with Advanced-Stage Cancer Referred for Palliative Radiation Therapy in an Outpatient Setting

Fan, Grace; Hadi, Stephanie; Chow, Edward

doi:10.3816/sct.2007.n.010

Cited by 53 publications

(48 citation statements)

References 13 publications

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“…Comparing our results to studies that specifically report ESAS scores from a palliative care unit or clinic, 26,27,[31][32][33][34][35][36][37][38] the symptom prevalence and symptom scores from these palliative patients are consistently higher than in our study. For example, in a study of 1296 patients attending a palliative radiation oncology outpatient clinic, 26 the median symptom score was 5 for fatigue, 2 for dyspnea, 3 for pain, and 2 for depression compared with our results of 3, 0, 1, and 0, respectively.…”

Section: Sarcomacontrasting

confidence: 48%

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Barbera

Seow

Howell

et al. 2010

Cancer

193

128

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BACKGROUND. For ambulatory cancer patients, Ontario has standardized symptom and performance status assessment population-wide, using the Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS). In a broad cross-section of cancer outpatients, the authors describe the ESAS and PPS scores and their relation to patient characteristics. METHODS. This is a descriptive study using administrative healthcare data. RESULTS. The cohort included 45,118 and 23,802 patients' first ESAS and PPS, respectively. Fatigue was most prevalent (75%), and nausea least prevalent (25%) in the cohort. More than half of patients reported pain or shortness of breath; about half of those reported moderate to severe scores. Seventy-eight percent had stable performance status scores. On multivariate analysis, worse ESAS outcomes were consistently seen for women, those with comorbidity, and those with shorter survivals from assessment. Lung cancer patients had the worst burden of symptoms. CONCLUSIONS. This is the first study to report ESAS and PPS scores in a large, geographically based cohort with a full scope of cancer diagnoses, including patients seen earlier in the cancer trajectory (ie, treated for cure). In this ambulatory cancer population, the high prevalence of numerous symptoms parallels those reported in palliative populations and represents a target for improved clinical care. Differences in outcomes for subgroups require further investigation. This research sets the groundwork for future research on patient and provider outcomes using linked administrative healthcare data. Cancer 2010;116:5767-76.

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Section: Sarcomacontrasting

confidence: 48%

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Barbera

Seow

Howell

et al. 2010

Cancer

193

128

View full text Add to dashboard Cite

show abstract

“…In our study, we clearly defined a 0.6 cut-off for the factor loading score. In some previous studies [12,18], this value was neither explicitly set in advance nor specifically listed for individual symptoms, leading to the possibility of post hoc definitions of clusters with various factor loading scores. In addition, several studies chose to use different cut-off values, which ranged from 0.4 to 0.9 [8,11,21,39].…”

Section: Discussionmentioning

confidence: 99%

Symptom clusters in patients with advanced cancers

Cheung

Zimmermann

2009

Support Care Cancer

140

114

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“…For maximum effect of PMR regular daily practice for 3-6 weeks is necessary. 31,32 In order to detect the full effect of the intervention as well as changes in the intensity of symptoms expected to become gradually worse as RT progressed with a peak at around week [3][4][5][6]33 and the longer term effects of the intervention some months after RT had finished, a repeated measures design was adopted to detect the pattern of changes over time.…”

Section: Data Collection Proceduresmentioning

confidence: 99%

“…Although radiation treatment (RT) can manage endobronchial or extrinsic lesions of lung cancer and lengthen a patient's life, 2 it can also cause severe side effects that compromise quality of life. Patients with advanced lung cancer undergoing RT are particularly vulnerable to the symptoms of breathlessness, fatigue and anxiety [3][4][5] which impact on patient function. [6][7][8] Patients with lung cancer often experience symptoms concurrently and they usually have overlapping and interactive effects.…”

Section: Introductionmentioning

confidence: 99%

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Managing Symptoms in Patients with Advanced Lung Cancer During Radiotherapy: Results of a Psychoeducational Randomized Controlled Trial

Chan

Richardson

2011

Journal of Pain and Symptom Management

122

114

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(250 words)Context: Breathlessness, fatigue, and anxiety are distressing symptoms for patients with advanced lung cancer. Usually managed as isolated symptoms, they can often occur simultaneously. Previous research has often addressed management of discrete symptoms rather than considering them as a cluster, which in reality is the situation faced by patients.Objectives: This study aims to examine the effectiveness of a psychoeducational intervention (PEI) on the symptom cluster of anxiety, breathlessness and fatigue, compared with usual care. Methods:A pre-test post-test 2-group randomized controlled trial was conducted.Education on symptom management and coaching in the use of progressive muscle relaxation were delivered to patients one week prior to commencing radiotherapy (RT), and repeated 3 weeks after the first. Symptom data were collected at 4 time points: prior to the intervention, 3 weeks, 6 weeks, and 12 weeks post intervention.Results: 140 lung cancer patients receiving palliative RT were recruited from a public funded hospital in Hong Kong. Doubly multivariate MANOVA revealed a significant difference (Time *group interaction effect, p = .003) over time between the PEI and usual care control group on the pattern of change of the symptom cluster. Significant effects on the patterns of changes in breathlessness (p = .002), fatigue (p = .011), anxiety (p = .001) and functional ability (p = .000) were also found. 4Conclusions: PEI was a promising treatment for relieving the symptom cluster and each of the individually assessed symptoms. More effort needs to be directed at studying impact of interventions on common symptom clusters.

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Symptom Clusters in Patients with Advanced-Stage Cancer Referred for Palliative Radiation Therapy in an Outpatient Setting

Cited by 53 publications

References 13 publications

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Symptom clusters in patients with advanced cancers

Managing Symptoms in Patients with Advanced Lung Cancer During Radiotherapy: Results of a Psychoeducational Randomized Controlled Trial

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