Deodhar Jayita Kedar, Noronha Vanita, Muckaden Mary Ann, Atreya Shrikant, Joshi Amit, Tandon Sandeep P, Ghoshal Arunangshu, Salins Naveen S, Patil Vijay M, Prabhash Kumar
Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Indian J Palliat Care. 2017 Jul-Sep;23(3):261-267. doi: 10.4103/IJPC.IJPC_19_17.
Early palliative care is beneficial in advanced lung cancer patients. We aimed to assess the feasibility of introducing early palliative care in ambulatory advanced lung cancer patients in an Indian tertiary cancer center.
In a longitudinal, single-arm, and single-center study, fifty patients were recruited and followed up every 3-4 weeks for 6 months, measuring the symptom burden using Edmonton Symptom Assessment Scale (ESAS) and quality of life (QoL) with European Organization for Research and Treatment of Cancer-QoL tools. The primary end point of feasibility was that at least 60% of the patients should complete 50% of the planned palliative care visits and over 50% of the patients should complete QoL questionnaires. Analysis was done using Statistical Package for the Social Sciences version 20.
Twenty-four of fifty patients (48%) completed the planned follow-up visits. All patients completed the questionnaires at baseline and 31 (62%) at their follow-up visits. The patients' main reasons for not following up in the hospital palliative care clinic were logistics and fatigue. Tiredness, pain, and appetite loss were the highest rated symptoms at baseline (ESAS scores 3, 2.2, and 2.1, respectively). Improvement in pain and anxiety scores at follow-up visits 1 and 2 was significant ( < 0.05). Scores on QoL functioning scales improved during the follow-up period.
We did not meet the feasibility criteria for the introduction of early palliative care in our advanced lung cancer patients in a resource-limited country.
早期姑息治疗对晚期肺癌患者有益。我们旨在评估在印度一家三级癌症中心为门诊晚期肺癌患者引入早期姑息治疗的可行性。
在一项纵向、单臂、单中心研究中,招募了50名患者,每3 - 4周进行一次随访,为期6个月,使用埃德蒙顿症状评估量表(ESAS)测量症状负担,并使用欧洲癌症研究与治疗组织生活质量工具评估生活质量(QoL)。可行性的主要终点是至少60%的患者应完成计划姑息治疗就诊的50%,且超过50%的患者应完成生活质量问卷调查。使用社会科学统计软件包第20版进行分析。
50名患者中有24名(48%)完成了计划的随访就诊。所有患者在基线时均完成了问卷调查,随访时31名(62%)完成了问卷。患者未在医院姑息治疗门诊随访的主要原因是后勤问题和疲劳。疲倦、疼痛和食欲减退是基线时评分最高的症状(ESAS评分分别为3、2.2和2.1)。随访第1次和第2次时疼痛和焦虑评分的改善具有显著性(<0.05)。随访期间生活质量功能量表的评分有所改善。
在一个资源有限的国家,我们未达到在晚期肺癌患者中引入早期姑息治疗的可行性标准。