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J. Vardy



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    MINI 28 - Psychological Impact of Lung Cancer and its Treatment (ID 150)

    • Event: WCLC 2015
    • Type: Mini Oral
    • Track: Palliative and Supportive Care
    • Presentations: 1
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      MINI28.01 - The Impact of Physical Activity on Fatigue and Quality of Life in Lung Cancer Patients: A Randomized Controlled Trial (RCT) (ID 3173)

      16:45 - 16:50  |  Author(s): J. Vardy

      • Abstract
      • Presentation
      • Slides

      Background:
      Physical activity (PA) has been shown to improve fatigue and quality of life (QOL) in a range of cancer populations. Little research has been done in the advanced lung cancer setting. This RCT evaluated a 2-month PA intervention in patients with unresectable lung cancer.

      Methods:
      Participants were stratified (disease stage, performance status [PS] 0-1 vs 2, centre) and randomized (1:1) to usual care (UC) (general nutrition and PA education materials) or UC plus 2-month program of supervised weekly PA and behaviour change sessions and home-based PA. Assessments were completed at baseline, 2, 4 and 6 months. The primary endpoint was fatigue (FACT-F subscale) at 2-months. Secondary endpoints included: QOL, functional abilities, physical fitness, activity (accelerometers), mood, dyspnea, survival and blood results. Intention-to-treat analysis using linear mixed models was done.

      Results:
      111 patients were randomized: male 55%, median age 62 (35-80); 95% NSCLC, 5% SCLC; 95% Stage IV. At baseline 77% were on active treatment. Baseline characteristics, including PA levels, comorbidities and Glasgow Prognostic Score (GPS) were well balanced between groups. Attrition was 22, 36 and 50% at 2, 4 and 6 months respectively; no difference between groups. Adherence to intervention sessions: behavioral 77%, PA 69%. There were no significant differences in fatigue, QOL, symptoms, mood, distress, sleep, dyspnea, activities of daily living, GPS between the groups at 2, 4 or 6 months. Patients over report PA levels compared to accelerometer data. Using accelerometer data, PA only increased in the PA group from 0 – 2 months, but the difference in PA between groups was not significant. Median survival (months): PA 13.7 vs UC 12.6 (p= 0.76): 38 participants remain alive.

      PA n=55 UC n=56 p-value
      FACT-F Fatigue: 0 2 4 6 38.4 37.5 39.6 36.6 36.3 36.3 35.4 34.5 0.61 0.10 0.44
      EORTC Global QOL 0 2 4 6 63.8 63.2 64.2 60.8 58.9 64.3 60.2 54.2 0.81 0.45 0.26
      Performance Status 0 2 4 6 0.8 0.8 0.8 0.7 0.9 1.0 1.0 1.2 0.30 0.16 0.01


      Conclusion:
      Adherence to the 8-week intervention was good but did not increase PA levels compared to education materials alone. No difference was seen in fatigue, QOL, symptom control or functional status.

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    P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
    • Presentations: 1
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      P2.08-004 - Healthcare Professional Perceptions of Chemotherapy in Treatment of Malignant Pleural Mesothelioma (MPM) (ID 3240)

      09:30 - 09:30  |  Author(s): J. Vardy

      • Abstract

      Background:
      Background: An evidence-based chemotherapy utilisation model for MPM suggests rates of use should be around 65%. Actual Australian rates are about 54%. Aim: To examine healthcare professional perceptions of chemotherapy use and barriers to it in MPM patients.

      Methods:
      Methods: Healthcare professionals caring for people with MPM were invited via email from professional groups, to complete a purpose designed online survey. Data were collected from January-July 2014. Descriptive data are presented.

      Results:
      Results: Surveys were completed by 102 doctors (Respiratory Physicians=53, Medical Oncologists (MO)=35, Other=15) and 19 nurses. Doctors mean age 47 (31-75) years, 74% male, 49% worked only in public system, 57% did not have lung cancer nurse specialist, and saw mean of 7 new patients with MPM annually. Nurses mean age 45 (29-68) years, all female, 53% worked only in public system, and saw mean of 12 (1-40) new patients with MPM annually. 74% of doctors and 53% of nurses believed >11% of MPM patients potentially eligible for chemotherapy do not receive it. Clinician barriers most commonly endorsed include: clinician nihilism 70%, 37%; non-referral to MO 47%, 63%; lack of cancer services 43%, 53%; no MDT review 40%, 32% for doctor, nurse respectively. 74% of nurses also indicated delayed diagnosis and 58% lack of clinician knowledge about treatment.

      Conclusion:
      Conclusions: Healthcare professionals’ estimates of potentially eligible patients with MPM who do not receive chemotherapy are consistent with or higher than evidence-based estimates. Barriers to chemotherapy access endorsed suggest strategies to increase knowledge of evidence-based treatment and address clinical nihilism are required.