This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Temel, J. S. Articles by Lynch, T. J. Search for Related Content PubMed PubMed Citation Articles by Temel, J. S. Articles by Lynch, T. J. Social Bookmarking                            What's this?

Phase II Study: Integrated Palliative Care in Newly Diagnosed Advanced Non–Small-Cell Lung Cancer Patients

Jennifer S. Temel, Vicki A. Jackson, J. Andrew Billings, Constance Dahlin, Susan D. Block, Mary K. Buss, Patricia Ostler, Panos Fidias, Alona Muzikansky, Joseph A. Greer, William F. Pirl, Thomas J. Lynch

From the Massachusetts General Hospital; and the Dana-Farber Cancer Institute, Boston, MA

Address reprint requests to Jennifer S. Temel, MD, Massachusetts General Hospital, Yawkey 7B, 55 Fruit St, Boston, MA 02114; e-mail: jtemel{at}partners.org

Purpose To assess the feasibility of early palliative care in the ambulatory setting in patients with newly diagnosed advanced non–small-cell lung cancer (NSCLC).

Patients and Methods Patients were eligible if they had a performance status of 0 to 1 and were within 8 weeks of diagnosis of advanced NSCLC. Participants received integrated care from oncology and palliative care throughout the course of their disease. Participants were scheduled to meet with the palliative care team (PCT) and complete quality-of–life (QOL) and mood questionnaires monthly for 6 months. The study was deemed feasible if 64% of patients completed at least 50% of their scheduled visits and QOL assessments.

Results Fifty-one patients were enrolled onto the trial. One died within 72 hours and was not assessable. Ninety percent (95% CI, 0.78 to 0.96) of study participants complied with at least 50% of the palliative care visits. Eight-six percent (95% CI, 0.73 to 0.94) of the participants met the full feasibility requirements by both meeting with the PCT and completing QOL assessments at least 50% of the time. QOL and mood analyses confirmed the high symptom burden in patients with newly diagnosed advanced NSCLC. At least 50% of participants experienced some degree of shortness of breath, cough, difficulty breathing, appetite loss, weight loss, or unclear thinking at their baseline assessment. More than one third of patients had a probable mood disorder at baseline.

Conclusion Integrated palliative and oncology care is feasible in ambulatory patients with advanced NSCLC.

Supported by an investigator-initiated research grant from Amgen (J.S.T.).

Presented in part at the 41st Annual Meeting of the American Society of Clinical Oncology, Orlando, FL, May 13-17, 2005, and the 11th World Lung Cancer Conference, Barcelona, Spain, July 3-6, 2005.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. Follwell, D. Burman, L. W. Le, K. Wakimoto, D. Seccareccia, J. Bryson, G. Rodin, and C. Zimmermann Phase II Study of an Outpatient Palliative Care Intervention in Patients With Metastatic Cancer J. Clin. Oncol., January 10, 2009; 27(2): 206 - 213. [Abstract] [Full Text] [PDF]

				J. H. Von Roenn, F. Strasser, and C. F. von Gunten Update on the Integration of Palliative Care into Cancer Care ASCO Educational Book, January 1, 2009; 2009(1): 590 - 596. [Abstract] [Full Text] [PDF]

				S. E. Harrington and T. J. Smith The Role of Chemotherapy at the End of Life: "When Is Enough, Enough?" JAMA, June 11, 2008; 299(22): 2667 - 2678. [Abstract] [Full Text] [PDF]

				W. F. Pirl, J. S. Temel, A. Billings, C. Dahlin, V. Jackson,, H. G. Prigerson, J. Greer, and T. J. Lynch Depression After Diagnosis of Advanced Non-Small Cell Lung Cancer and Survival: A Pilot Study Psychosomatics, May 1, 2008; 49(3): 218 - 224. [Abstract] [Full Text] [PDF]

				C. Zimmermann, R. Riechelmann, M. Krzyzanowska, G. Rodin, and I. Tannock Effectiveness of Specialized Palliative Care: A Systematic Review JAMA, April 9, 2008; 299(14): 1698 - 1709. [Abstract] [Full Text] [PDF]