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D. Michel-Tello



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    MA 08 - Supportive Care and Communication (ID 669)

    • Event: WCLC 2017
    • Type: Mini Oral
    • Track: Nursing/Palliative Care/Ethics
    • Presentations: 1
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      MA 08.10 - Favorable Clinical Status Predicts Benefit From Early-Palliative Cares & OS Improvement in NSCLC: A Randomized Clinical Study (ID 10348)

      12:05 - 12:10  |  Author(s): D. Michel-Tello

      • Abstract
      • Presentation
      • Slides

      Background:
      Early-palliative care (EPC) after lung cancer diagnosis is essential for a better quality-of-life (QoL), and even offers a substantial improvement in survival outcomes. We prospectively assessed the effect of EPC in overall survival (OS) and patient-reported outcomes in non-small cell lung cancer (NSCLC) patients.

      Method:
      Newly-diagnosed and treatment-naïve NSCLC patients were included and randomly assigned (1:1) to receive either EPC with oncologic, nutritional, and psychological care, or standard oncologic care alone. Assessments were performed at baseline, second, fourth and sixth cycle of chemotherapy, with evaluations including: QoL, evaluated by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, depression and anxiety which were evaluated using the Hospital Anxiety and Depression Scale, and oncologic symptomatology, which was evaluated with the Edmonton System Assessment Scale. NCT01631565 [013/020ICI(CV773/13)].

      Result:
      Ninety-six NSCLC patients were enrolled; 42 patients were allocated to EPC while 54 patients were allocated to standard-care. Overall, patients receiving EPC have lower self-reported symptoms, depression and anxiety. Median OS of patients with EPC was 11.1 months (95% CI: 8.4–13.9), while in patients with standard-care was 5.9 months (95% CI: 4.8 – 7.1); p=0.049. In the multivariate analysis, factors associated with worse OS were: patients in standard-care arm (HR, 95% CI 1.6 (0.9 – 2.7); p=0.05), male patients (HR, 95% CI 1.8 (1.1 – 3.0); p=0.028) and worse ECOG performance status (≥2) (HR, 95% CI 1.9 (1.0 – 3.5); p=0.039).In a subgroup analysis, patients who reaped the most benefit from EPC included those with better ECOG performance status (<2) (8.9 vs. 5.7 months; p=0.05); those without depression at baseline (14.8 vs. 6.5 months; p=0.05) and those Corroborar que si sea mayor ansiedad basal-mayor beneficio Figure 1



      Conclusion:
      EPC might provide benefit in the clinical symptomatic burden and OS of NSCLC patients. Benefits from EPC in OS might be associated to favorable global clinical status.

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