TY - JOUR
T1 - Longitudinal changes in function, symptom burden, and quality of life in patients with early-stage lung cancer
AU - Koczywas, Marianna
AU - Williams, Anna Cathy
AU - Cristea, Mihaela
AU - Reckamp, Karen
AU - Grannis, Frederic W.
AU - Tiep, Brian L.
AU - Uman, Gwen
AU - Ferrell, Betty
N1 - Funding Information:
The investigators in this study have conducted previous studies adding to the recognition of needs for lung cancer patients across all stages.13–15 Whereas the palliative care needs for those with stage IV is well established, the authors’ research have documented that patients with stages I–III disease also experience multiple symptoms, psychosocial needs, and living with the uncertainty of possible recurrence. These previous studies led to funding from the National Cancer Institute for a Program Project Grant (P01) to develop a palliative care intervention for lung cancer and compare it across three populations of early stage (stage I–III), late stage (stage IV), and family caregivers. This paper reports on the usual care phase of the early-stage project and how the findings informed the development of the palliative care intervention.
Funding Information:
ACKNOWLEDGMENT The research described was supported by grant 5 P01 CA136396-02 from the National Cancer Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or NIH.
PY - 2013/6
Y1 - 2013/6
N2 - Background: Emerging evidence supports the integration of palliative care concurrently with disease-focused care in patients with serious illnesses, such as lung cancer. This paper describes how longitudinal changes in physical function, symptom burden, and QOL of patients with early-stage non-small cell lung cancer (NSCLC) informed the development of an interdisciplinary, tailored palliative care intervention. Methods: Patients with early stage (I-IIIB) NSCLC were accrued into the usual care phase (Phase 1) of an NCI-funded Program Project Grant. Baseline and longitudinal (up to 52 weeks post-accrual) physical function, symptoms, and QOL were assessed in the thoracic ambulatory clinics of one NCI-designated Comprehensive Cancer Center. Outcome measures included geriatric assessments, psychological distress, symptoms, and QOL. The association between disease stage (I-II vs. III) and longitudinal changes in these domains was evaluated. Results: A total of 103 patients were accrued. Stage I-II patients were significantly more likely to complete the study (p = 0.005). The stages (I-II vs. III) were equivalent at baseline on all demographic variables, clinical, and functional status. Physical function fluctuated longitudinally and was higher at 6 and 24 weeks than at baseline and 12 weeks. There was a longitudinal decrease in total number of symptoms (p < 0.001). Physical and social/family QOL fluctuated longitudinally (p < 0.001 and p = 0.016, respectively). Conclusions: Patients with early-stage NSCLC report a significant longitudinal decrease in physical QOL, and fluctuations in objective and subjective measures of physical function over time were observed regardless of disease stage category. An interdisciplinary palliative care intervention is currently being tested to decrease symptom burden and improve QOL.
AB - Background: Emerging evidence supports the integration of palliative care concurrently with disease-focused care in patients with serious illnesses, such as lung cancer. This paper describes how longitudinal changes in physical function, symptom burden, and QOL of patients with early-stage non-small cell lung cancer (NSCLC) informed the development of an interdisciplinary, tailored palliative care intervention. Methods: Patients with early stage (I-IIIB) NSCLC were accrued into the usual care phase (Phase 1) of an NCI-funded Program Project Grant. Baseline and longitudinal (up to 52 weeks post-accrual) physical function, symptoms, and QOL were assessed in the thoracic ambulatory clinics of one NCI-designated Comprehensive Cancer Center. Outcome measures included geriatric assessments, psychological distress, symptoms, and QOL. The association between disease stage (I-II vs. III) and longitudinal changes in these domains was evaluated. Results: A total of 103 patients were accrued. Stage I-II patients were significantly more likely to complete the study (p = 0.005). The stages (I-II vs. III) were equivalent at baseline on all demographic variables, clinical, and functional status. Physical function fluctuated longitudinally and was higher at 6 and 24 weeks than at baseline and 12 weeks. There was a longitudinal decrease in total number of symptoms (p < 0.001). Physical and social/family QOL fluctuated longitudinally (p < 0.001 and p = 0.016, respectively). Conclusions: Patients with early-stage NSCLC report a significant longitudinal decrease in physical QOL, and fluctuations in objective and subjective measures of physical function over time were observed regardless of disease stage category. An interdisciplinary palliative care intervention is currently being tested to decrease symptom burden and improve QOL.
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U2 - 10.1245/s10434-012-2741-4
DO - 10.1245/s10434-012-2741-4
M3 - Article
C2 - 23143593
AN - SCOPUS:84878263470
SN - 1068-9265
VL - 20
SP - 1788
EP - 1797
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 6
ER -