Early palliative care and quality of life of advanced cancer patients—a multicenter randomized clinical trial
| Autor: | Letizia Bocchi, Valentina Scafuri, Michela Monfredo, Giuseppe Caruso, Luigi Cavanna, Vittorio Franciosi, M. Sequino, Cinzia Binovi, Erico Piva, Gianpaolo Bacchini, Pamela Di Cesare, Caterina Caminiti, Barbara Melotti, Giuseppe Maglietta, Raffaella Bertè, F. Ghisoni, Anita Rimanti, Claudia Degli Esposti |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms Palliative care law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Quality of life Stomach Neoplasms law Carcinoma Non-Small-Cell Lung Pancreatic cancer Internal medicine medicine Humans Prospective Studies 030212 general & internal medicine Lung cancer Advanced and Specialized Nursing business.industry Palliative Care Cancer Middle Aged medicine.disease Community hospital Pancreatic Neoplasms Biliary Tract Neoplasms Treatment Outcome Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Quality of Life Female business Psychosocial |
| Zdroj: | Annals of Palliative Medicine. 8:381-389 |
| ISSN: | 2224-5839 2224-5820 |
| DOI: | 10.21037/apm.2019.02.07 |
| Popis: | Background: To compare quality of life (QoL) of patients receiving early palliative care (EPC) vs . standard oncologic care (SOC). Methods: Pragmatic, multicenter, randomized trial at five University and Community Hospital Cancer Centers in Northern Italy. Advanced non-small cell lung, gastric, pancreatic and biliary tract cancer patients diagnosed within the previous 8 weeks. In the EPC arm, visits were performed systematically by a dedicated physician/nurse palliative care (PC) team, who assessed physical and psychosocial symptoms, and enacted the necessary services. In the SOC arm, PC visits were only carried out if requested. The primary outcome was the difference in the change of QoL [Functional Assessment of Cancer Therapy-General measure (FACT-G)] from baseline to 12 weeks in the two groups. Results: From November 2014 to March 2016, 281 patients were enrolled (142 EPC, 139 SOC); 218 completed FACT-G at 12 weeks. Baseline demographic and clinical characteristics were similar for the two groups. Values of FACT-G at baseline and 12 weeks were 72.3 (SD 12.6) and 70.1 (SD 15.5) for patients enrolled in the EPC arm, vs . 71.7 (SD 14.7) and 69.6 (SD 15.5) for the SOC arm, but the change scores did not differ significantly between groups. In the multivariable analysis, adjusting for QoL at baseline, two potential prospective prognostic factors were statistically significant: lung cancer (P=0.03) and interaction of living without a partner and intervention arm (P=0.01). Dying within 6 months (P Conclusions: In this study, EPC did not improve QoL in advanced cancer patients, but our findings highlight aspects which may guide future research on EPC. |
| Databáze: | OpenAIRE |
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