Document Detail

Longitudinal changes in function, symptom burden, and quality of life in patients with early-stage lung cancer.
MedLine Citation:
PMID:  23143593     Owner:  NLM     Status:  MEDLINE    
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.
Marianna Koczywas; Anna Cathy Williams; Mihaela Cristea; Karen Reckamp; Frederic W Grannis; Brian L Tiep; Gwen Uman; Betty Ferrell
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-11-10
Journal Detail:
Title:  Annals of surgical oncology     Volume:  20     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-17     Completed Date:  2013-12-23     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1788-97     Citation Subset:  IM    
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MeSH Terms
Activities of Daily Living
Aged, 80 and over
Analysis of Variance
Carcinoma, Non-Small-Cell Lung / pathology*,  physiopathology,  surgery*
Geriatric Assessment
Karnofsky Performance Status
Longitudinal Studies
Lung Neoplasms / pathology*,  physiopathology,  surgery*
Middle Aged
Neoplasm Staging
Nutrition Therapy
Palliative Care*
Physical Therapy Modalities
Prospective Studies
Quality of Life*
Referral and Consultation
Social Participation
Social Support
Social Work
Grant Support
5 P01 CA136396-02/CA/NCI NIH HHS; P01 CA136396/CA/NCI NIH HHS

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