King Jonathan D, Eickhoff Jens, Traynor Anne, Campbell Toby C
Community Hospital, Grand Junction, Colorado, USA.
Department of Biostatistics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
J Pain Symptom Manage. 2016 Jun;51(6):1027-32. doi: 10.1016/j.jpainsymman.2016.01.003. Epub 2016 Mar 4.
Lung cancer is the leading cause of cancer-related death in the U.S. A large randomized controlled trial in advanced lung cancer found a survival advantage with an early palliative care (EPC) intervention compared to standard oncologic care.
We performed retrospective analysis of our partially integrated onco-palliative care lung cancer clinic to evaluate overall survival and resource utilization.
All outpatients with advanced lung cancer cared for within our institution from 2007 to 2011 were identified. Overall survival, clinical trial participation, hospice enrollment and length of stay, and chemotherapy utilization were calculated for patients treated with EPC and compared to standard oncologic care.
Two hundred seven patients with advanced lung cancer were identified; 82 received EPC. EPC patients had a survival advantage (11.9 vs. 10.1 months, P = 0.031), were more likely to participate in clinical trials (29% vs. 19%, P = 0.014), and median hospice length of stay was longer (38.5 vs. 24 days, P = 0.032). No difference in chemotherapy utilization or hospice enrollment was seen between the groups.
EPC in advanced lung cancer was associated with a nearly two-month survival advantage compared to standard oncologic care. This finding provides supportive evidence to previously published reports of survival benefit with EPC intervention. Clinical trial participation rates in advanced lung cancer are lacking, and we found more frequent clinical trial participation in the early PC group. No differences were seen in chemotherapy utilization or hospice enrollment. EPC patients' longer hospice length of stay did not compromise survival.
肺癌是美国癌症相关死亡的主要原因。一项针对晚期肺癌的大型随机对照试验发现，与标准肿瘤治疗相比，早期姑息治疗（EPC）干预具有生存优势。
我们对部分整合的肿瘤姑息治疗肺癌诊所进行了回顾性分析，以评估总生存期和资源利用情况。
确定了2007年至2011年在我们机构接受治疗的所有晚期肺癌门诊患者。计算接受EPC治疗的患者的总生存期、临床试验参与率、临终关怀登记情况和住院时间，以及化疗利用率，并与标准肿瘤治疗进行比较。
确定了207例晚期肺癌患者；82例接受了EPC治疗。EPC治疗的患者具有生存优势（11.9个月对10.1个月，P = 0.031），更有可能参与临床试验（29%对19%，P = 0.014），临终关怀的中位住院时间更长（38.5天对24天，P = 0.032）。两组之间在化疗利用率或临终关怀登记方面没有差异。
与标准肿瘤治疗相比，晚期肺癌的EPC治疗具有近两个月的生存优势。这一发现为先前发表的关于EPC干预生存获益的报告提供了支持性证据。晚期肺癌的临床试验参与率较低，我们发现早期姑息治疗组的临床试验参与更为频繁。在化疗利用率或临终关怀登记方面没有差异。EPC治疗患者较长的临终关怀住院时间并未影响生存。
