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  P2.24 - Poster Session 2 - Supportive Care (ID 157)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11993

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    P2.24-047 - Palliative Care Units in the management of patients with advanced lung cancer - the experience of the Medical University of Vienna (ID 2857)

    09:30 - 09:30  |  Author(s): E.K. Masel
    • Abstract

    Background
    Patients with advanced lung cancer suffer from a high burden of tumor-related symptoms. Thus palliative care is an important treatment modality in these patients. Palliative care units have been established in many comprehensive cancer centers in order to achieve this. Here we report on the experience we have obtained at the Palliative Care Unit of the Medical University of Vienna in the management of patients with advanced lung cancer.

    Methods
    We retrospectively reviewed medical records of 86 patients with advanced lung cancer who were treated at our Palliative Care Unit between June 2010 and March 2013. We determined reasons for admission, duration of hospitalization, non-invasive as well as invasive medical interventions, and clinical outcome.

    Results
    We report on 86 patients with advanced lung cancer (74 % NSCLC, 26 % SCLC) who had been admitted to our Palliative Care Unit within a period of 34 months. Lung cancer patients comprised the largest group of cancer patients who are admitted to our unit. Reasons for admissions were deterioration of performance status (41 %), dyspnea (13 %), pain (38 %), psychosocial reasons (7 %), and other (1 %). Re-admissions occurred in 20 % of all patients. The patients had the following characteristics: median age 62 years (range 42-85 years), 38 % females and 62 % males, ECOG performance status 0-2 38 % and >2 62%, median body mass index (BMI) 24 (range 14-39). Median duration of hospitalization was 16 days (range 1-101 days). The following treatments were delivered during hospitalization: analgesic treatment according to the WHO I-III ladder (85 %), palliative radiotherapy (31 %), palliative chemotherapy (7 %), and invasive procedures (such as thoracocentesis, pleurX drainage system, pleurodesis, bronchial stenting, invasive neurolysis and other in 26%). Antibiotic therapy was delivered in 33 % and antipressants or antipsychotropic drugs in 38 % of all patients. Palliative sedation by means of a continuous intravenous or subcutaneous infusion with midazolam was administered in 25%. Dietary counseling and spiritual as well as psychosocial support was offered to all patients and accepted by most of them. 77 % of all patients died during their stay, mostly due to disease progression. The remaining 23 % of all patients were discharged with improvements in their tumor related symptoms or stable disease and were offered home care or hospice access.

    Conclusion
    Patients with advanced lung cancer did benefit from admission to the Palliative Care Unit. Medical as well as non-medical interventions resulted in improvements of cancer-related symptoms and better coping with the disease. Thus Palliative Care Units should be part of the multidisciplinary management of patients with advanced lung cancer. Schur S and Masel EK contributed equally to this work