Effect of Early Palliative Care on Quality of Life of Advanced Head and Neck Cancer Patients: A Phase III Trial
| Autor: | Kumar Prabhash, Jayita Deodhar, Anuja Abhyankar, Nandini Menon, Vijay Patil, Vanita Noronha, Pankaj Singhai, Naveen Salins, Atanu Bhattacharjee, Sachin Dhumal, Amit Joshi, Mary Ann Muckaden, Rupali Tambe, Ashwini Khake |
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| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Palliative care Systemic therapy 03 medical and health sciences 0302 clinical medicine Quality of life Internal medicine medicine Clinical endpoint Humans 030212 general & internal medicine business.industry Random assignment Palliative Care Head and neck cancer Hazard ratio Editorials Cancer medicine.disease Oncology Head and Neck Neoplasms 030220 oncology & carcinogenesis Carcinoma Squamous Cell Quality of Life business |
| Zdroj: | J Natl Cancer Inst |
| ISSN: | 1460-2105 0027-8874 |
| DOI: | 10.1093/jnci/djab020 |
| Popis: | Background Early palliative care (EPC) is an important aspect of cancer management but, to our knowledge, has never been evaluated in patients with head and neck cancer. Hence, we performed this study to determine whether the addition of EPC to standard therapy leads to an improvement in the quality of life (QOL), decrease in symptom burden, and improvement in overall survival. Methods Adult patients with squamous cell carcinoma of the head and neck region planned for palliative systemic therapy were allocated 1:1 to either standard systemic therapy without or with comprehensive EPC service referral. Patients were administered the revised Edmonton Symptom Assessment Scale and the Functional Assessment of Cancer Therapy for head and neck cancer (FACT-H&N) questionnaire at baseline and every 1 month thereafter for 3 months. The primary endpoint was a change in the QOL measured at 3 months after random assignment. All statistical tests were 2-sided. Results Ninety patients were randomly assigned to each arm. There was no statistical difference in the change in the FACT-H&N total score (P = .94), FACT-H&N Trial Outcome Index (P = .95), FACT-general total (P = .84), and Edmonton Symptom Assessment Scale scores at 3 months between the 2 arms. The median overall survival was similar between the 2 arms (hazard ratio for death = 1.01, 95% confidence interval = 0.74 to 1.35). There were 5 in-hospital deaths in both arms (5.6% for both, P = .99). Conclusions In this phase III study, the integration of EPC in head and neck cancer patients did not lead to an improvement in the QOL or survival. |
| Databáze: | OpenAIRE |
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