1593MO - Combined early palliative care in patients with non small cell lung cancer: A randomised controlled trial in Chongqing, China

Background

Effective interventions to improve prognosis in non-small-cell lung cancer (NSCLC) are urgently needed. We assessed the effect of the early integration of interdisciplinary palliative care (based on Ewarm model) for patients with NSCLC on the quality of life (QoL), psychological state, cancer pain and nutritional status.

Methods

In this randomised controlled trial, 280 newly diagnosed NSCLC patients were enrolled and randomly assigned (1:1) to the combined early palliative care (CEPC) group integrated with standard oncologic care or standard oncological care (SC) group. QoL and psychological state were assessed at baseline and at 24 weeks by Functional Assessment of Cancer Therapy-Lung (FACT-L) scale, the Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire-9 (PHQ-9), respectively. Cancer nutritional and pain status were assessed with the use of the Patient-Generated Subjective Global Assessment (PG-SGA) and Numerical Rating Scale (NRS), respectively. The primary end point was overall survival (OS). The second end point was the change in the quality of life, psychological state, pain and nutritional status at 24 weeks. Analysis was by intention to treat.

Results

280 patients were enrolled: 140 in CEPC group (102 completed) and 140 in the SC group (82 completed). CEPC group had a better QoL than SC group (all P < 0.05). In addition, fewer patients in the CEPC group than in the SC group had depressive (P < 0.05) symptoms. Furthermore, patients in CEPC group had a better nutritional status and pain than SC group (P =0.007 and P =0.003). Patients in the CEPC group had significantly longer survival than those in the SC group (median OS, 24.6 vs. 20.4 months; P=0.042) (HR, 0.19; 95% CI, 0.04 to 0.85; P=0.029).

Conclusions

Among patients with non-small-cell lung cancer, early palliative care led to significant improvements in longer survival, quality of life, psychological state, pain and nutritional status.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.