Palliative care improves timing of final chemotherapy and transition to hospice services
THURSDAY, Dec. 29 (HealthDay News) -- Early palliative care for patients with terminal non-small-cell lung cancer (NSCLC) improves the timing of final chemotherapy administration and is associated with an earlier transition to hospice care, according to a study published online Dec. 27 in the Journal of Clinical Oncology.
Joseph A. Greer, M.D., of the Massachusetts General Hospital Cancer Center in Boston, and colleagues investigated whether early palliative care affected the frequency and timing of chemotherapy use and hospice care for patients with metastatic NSCLC. This 18-month study involved 151 tertiary care patients with newly diagnosed metastatic NSCLC who were randomized to receive either early palliative care integrated with standard oncology care or standard oncology care alone. Measures of outcome included the number and types of chemotherapy regimens, and the frequency and timing of chemotherapy administration and hospice referral.
Although the total number of chemotherapy regimens did not differ between the groups, the researchers found that patients receiving early palliative care in addition to standard oncology care were half as likely to receive chemotherapy within 60 days of death as those receiving standard oncology care alone. Additionally, the median interval between the last chemotherapy dose and death was about 24 days longer for those patients who received early palliative care. Although rates of referral to hospice did not differ between the groups, patients receiving palliative care had a higher rate of hospice care for longer than one week prior to death than those not receiving palliative care.
"By reducing intravenous chemotherapy use in the final months of life, patients assigned to early palliative care were able to access hospice services sooner than those in the standard care group and had durations of enrollment longer than one week before death, which is a clinically meaningful measure for quality end-of-life care. The innovative model of palliative care integrated into the outpatient setting soon after diagnosis of terminal cancer provides an alternate and efficacious approach to reconcile the needs of patients for symptom management and psychosocial support while simultaneously undergoing anticancer therapy," the authors write.
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