Ramos Katherine, Ayaz Aliza, Riley Jennie, Faircloth Kaylee, Porter Laura S, Strauman Timothy J
Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Department of Population Health Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Cancers (Basel). 2025 Aug 28;17(17):2809. doi: 10.3390/cancers17172809.
Advanced lung cancer is a highly distressing disease that negatively impacts older adults. Supportive care interventions designed for this population are scarce and often inaccessible due to competing demands and transportation access. We adapted and refined an evidence-based treatment, Self-System Therapy (SST), to address the unmet needs of older adults with advanced cancer. Guided by principles of implementation science, we conducted patient interviews, focus groups, and user testing to refine our new SST for the lung cancer (SST-LC) protocol. We then conducted a single-arm pilot trial (clinicaltrials.gov NCT04057196) for patients aged 65+ and above with Stage III or IV lung cancer (N = 30). Benchmarks for acceptability, feasibility, and preliminary changes in outcome measures were assessed. Our study met the desired recruitment goals and demonstrated high treatment adherence rates (89%) and satisfaction rates (85%), indicating that SST-LC was feasible and well-received. Participants also showed reductions in distress and depression, and improvements in emotional and functional well-being from baseline to post-intervention, with effects mostly maintained at follow-up. Physical well-being, social well-being, and quality of life showed smaller, non-significant changes. Feedback from participants also suggested that SST enhanced their resilience and ability to cope with cancer-related challenges, but also indicated a preference for fewer sessions. SST for older adults living with advanced lung cancer is feasible and acceptable. Moreover, this supportive care intervention shows promise in addressing psychological distress, emotional well-being, and functional well-being in older adults. Future research will include testing the efficacy of SST in a larger randomized controlled trial.
晚期肺癌是一种给老年人带来极大痛苦的疾病，会对他们产生负面影响。针对这一人群设计的支持性护理干预措施稀缺，而且由于需求竞争和交通不便，往往难以获得。我们对一种循证治疗方法——自我系统疗法（SST）进行了调整和完善，以满足晚期癌症老年患者未得到满足的需求。在实施科学原则的指导下，我们进行了患者访谈、焦点小组讨论和用户测试，以完善我们新的肺癌自我系统疗法（SST-LC）方案。然后，我们对年龄在65岁及以上的III期或IV期肺癌患者（N = 30）进行了单臂试点试验（clinicaltrials.gov NCT04057196）。评估了可接受性、可行性以及结局指标的初步变化的基准。我们的研究达到了预期的招募目标，显示出较高的治疗依从率（89%）和满意率（85%），表明SST-LC是可行的且受到广泛认可。从基线到干预后，参与者的痛苦和抑郁情绪也有所减轻，情绪和功能健康状况有所改善，且这些效果在随访时大多得以维持。身体状况、社会状况和生活质量的变化较小，且无统计学意义。参与者的反馈还表明，SST增强了他们的恢复力和应对癌症相关挑战的能力，但也表示希望减少治疗疗程。针对患有晚期肺癌的老年人的SST是可行且可接受的。此外，这种支持性护理干预措施在解决老年人的心理困扰、情绪健康和功能健康方面显示出前景。未来的研究将包括在更大规模的随机对照试验中测试SST的疗效。
