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K. Miyazaki
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P2.11 - Poster Session/ Palliative and Supportive Care (ID 230)
- Event: WCLC 2015
- Type: Poster
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.11-003 - Changes in Quality of Life Through the Early Intervention by a Palliative Care Team for Patients with Advanced Lung Cancer (ID 1098)
09:30 - 09:30 | Author(s): K. Miyazaki
- Abstract
Background:
The change in quality of life (QOL) through the early intervention by a palliative care team was analyzed in patients with advanced lung cancer. The contrast between patients’ own evaluation on their QOL and their QOL estimated by their attending physicians was examined as well.
Methods:
The eligibility criteria were newly-diagnosed Japanese patients with stage IV lung cancer, whose ages were over 20- years old, whose Eastern Cooperative Oncology Group Performance Status were from 0 to 3, and those who had written informed consent. For the patients and attending physicians, QOL questionnaires, which were in line European Organization for Research and treatment of Cancer Quality of Life Questionnaire-Core15 （EORTC QLQ c-15）, were conducted at the time of the enrollment and twelve weeks later. The primary endpoint was a change in global QOL score, which ranged from 0 (worst) to 100 (best), after the twelve-week intervention.
Results:
58 patients out of 96 who were newly diagnosed as stage IV lung cancer were enrolled in this study. 43 patients had the QOL evaluation after twelve weeks. One patient withdrew consent, one patient moved to another hospital and other thirteen patients died during the intervention period. The primary endpoint improved by more than 25% that was originally anticipated (50 points at the enrollment, 64.7 points after the intervention.). All of the following factors including emotional state, nausea, vomiting, pain, constipation improved by more than 25% similarly to the primary endpoints, although other QOL factors showed a slight improvement or no change. While the difference between the QOL score by the patients and the physicians was apparent at the beginning the intervention, it became smaller by every measurement after twelve weeks. In Japan, Palliative care units (PCUs) have a role of hospices as well, and there are not enough number of them, to meet the entire needs for the end-of-life care. Some patients end up dying while on the waiting lists of PCU. Less percentage of patients who had early palliative care (EPC) died while waiting PCU admission, as compared with other cancer patients who applied for PCU during the same period as the present study. (12.5 % vs 30.4 %) In addition, duration of best supportive care in patients were extended approximately one month, as compared with past patients with stage IV lung cancer in undergoing EPC.(108.7day vs 78day)
Conclusion:
QOL improved in studied Japanese patients after the early interventions by the palliative care team. This result may indicate that discrepancy of QOL evaluation between the patients and physicians was lessened due to the early intervention by the palliative care team, which is considered to have fostered the improvement of the overall QOL. It was suggested that such intervention might support the patients in decision making for end-of-life-care.
