CN6 - Integration of specialized mobile palliative unit care into management of patients with thoracic malignancies: A single center experience

Background

Integration of specialized palliative care may provide better symptom control, reduce number of hospital referrals and prolong survival of patients (pts) with cancer. Mobile Palliative Unit (MPU) offers specialized support to pts and their relatives in home setting. Patients with thoracic malignancies, diagnosed and treated at University Clinic Golnik are referred to regional MPU based on the prognosis and need of management of their symptoms, especially in the metastatic setting. The aim of this study was to analyze the outcomes of pts included in MPU.

Methods

We retrospectively collected data from pts electronic hospital records regarding demographic data and information of referral to MPU, such as the time and reason for referral. In addition, data about actual inclusion, time of being included and outcomes were extracted from MPU records.

Results

From August 2020 until December 2023, there were 176 referrals to the MPU. Most of pts were male (57%) with non-small cell lung cancer, small cell lung cancer and malignant pleural mesothelioma in 73%, 17% and 10%, respectively. Thirteen percent of pts did not receive any systemic therapy; others received chemotherapy, immune checkpoint inhibitors and targeted therapy in 27%, 45% and 15%, respectively. Majority (97%) were referred to MPU by treating medical oncologist in a median of 64.5 days (range 0 – 2811 days) from first medical oncologist visit. Additionally, 52% of pts were included early in MPU in < 100 days. The reason for referral to MPU were pain (28%), dyspnea (11%), poor social circumstances (2%), deterioration of disease (16%) and need for supportive therapy escalation (27%), other pts had multiple reasons. There were 119 deaths until March 2024 with a median time from referral to death of 90.5 days (range 2 – 943 days). Most pts died at home (72%), some in a hospital or hospice (23%), whereas we have no data for 5% of pts.

Conclusions

Early integration of specialized MPU in the management of oncological pts is feasible and facilitates effective symptom control, that is essential to provide pts comfort in their last days and enables them to die at home, if possible.

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.