Early Palliative Care in Patients With Non–Small-Cell Lung Cancer: A Randomized Controlled Trial in Southwest China

Abstract

Purpose: 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 WARM model) for patients with NSCLC on the quality of life (QoL), psychological state, cancer pain and nutritional status. Methods: In this randomized controlled trial, 120 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 outcome was the change in the quality of life, psychological state and nutritional status at 24 weeks. Analysis was by intention to treat. Results: 120 patients were enrolled: 60 in CEPC group (38 completed) and 60 in the SC group (32 completed). CEPC group had a better QoL than SC group ( P < .05). In addition, fewer patients in the CEPC group than in the SC group had depressive ( P = .005) symptoms. Furthermore, patients in CEPC group had a better nutritional status than SC group ( P = .001). Conclusion: Among patients with non–small-cell lung cancer, early palliative care led to significant improvements in quality of life, psychological state and nutritional status.