Role of Symptomatic Management in Understanding Effects of Early Integration of Palliative Care among Nonmetastatic Lung Cancer Patients on Psychological Well-Being

Abstract

Aim. The impact of early referral to palliative care on quality of life for patients with lung cancer has already been discussed. However, the benefits of early integration of palliative care service (EIPCS) combined with standard oncology care for nonmetastatic lung cancer patients remain unclear. Hence, we designed a study to assess the impact of EIPCS among nonmetastatic cancer patients in India. Methods. In this randomized controlled trial study, we divided the data from 115 patients with diagnosed nonmetastatic lung cancer between age group of >18 years to ≥65 years. Following clinicopathological and radiology diagnosis, patients were referred to pain and palliative medicine department. Patients were randomly assigned by palliative physicians into two groups: Group A (N = 64), those who were receiving standard oncology care (chemotherapy or radiation or both) along with EIPCS, and Group B (N = 51), receiving standard oncology care. Patients were followed up every 3 weeks up to 3 months. Primary outcomes, symptoms’ burden, and psychological well-being were measured by validated tools. To define the impact of EIPCS, appropriate statistics were calculated as the mean ± standard deviation of the score of validated tools. Statistical significance was defined at $p<0.005$. Results. From the beginning, we had taken 115 patients, and on 42 days’ follow-up, the number of dropout patients for Group A was 3 (due to unable to contact), and for Group B, 9 (due to physical condition). This was followed by a reassessment after 126 days where dropout patients for Group A was 4 (due to unable to contact), and for Group B, 7 (due to physical condition). Following statistical report compliance at 126 days by WEMWBS was 21.16 ± 3.65 in Group A versus 16.1 ± 1.93 versus in Group B and by ESAS 51.84 ± 0.01 in Group A versus 97.64 ± 2.18 in Group B. Conclusion. The findings of this study showed that patients with nonmetastatic lung cancer who received standard oncology care combined with EIPCS had increased the psychological well-being and reduced symptoms burden.