Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial.
OBJECTIVE
The primary goal of this study was to evaluate the feasibility and effectiveness of a structured, multidisciplinary intervention targeted to maintain the overall quality of life (QOL), which is more comprehensive than psychosocial distress, of patients undergoing radiation therapy for advanced-stage cancer.


METHODS
Radiation therapy patients with advanced cancer and an estimated 5-year survival rate of 0% to 50% were randomly assigned to either an eight-session structured multidisciplinary intervention arm or a standard care arm. The eight 90-minute sessions addressed the five domains of QOL including cognitive, physical, emotional, spiritual, and social functioning. The primary end point of maintaining overall QOL was assessed by a single-item linear analog scale (Linear Analog Scale of Assessment or modified Spitzer Uniscale). QOL was assessed at baseline, week 4 (end of multidisciplinary intervention), week 8, and week 27.


RESULTS
Of the 103 participants, overall QOL at week 4 was maintained by the patients in the intervention (n = 49), whereas QOL at week 4 significantly decreased for patients in the control group (n = 54). This change reflected a 3-point increase from baseline in the intervention group and a 9-point decrease from baseline in the control group (P = .009). Intervention participants maintained their QOL, and controls gradually returned to baseline by the end of the 6-month follow-up period.


CONCLUSIONS
Although intervention participants maintained and actually improved their QOL during radiation therapy, control participants experienced a significant decrease in their QOL. Thus, a structured multidisciplinary intervention can help maintain or even improve QOL in patients with advanced cancer who are undergoing cancer treatment.
Rummans
Teresa A
TA
Department of Psychiatry and Psychology, Mayo Clinic Cancer Center, and Medical Social Services, Mayo Clinic, Rochester MN 55905, USA. rummans.teresa@mayo.edu
Clark
Matthew M
MM
Sloan
Jeff A
JA
Frost
Marlene H
MH
Bostwick
John Michael
JM
Atherton
Pamela J
PJ
Johnson
Mary E
ME
Gamble
Gail
G
Richardson
Jarrett
J
Brown
Paul
P
Martensen
James
J
Miller
Janis
J
Piderman
Katherine
K
Huschka
Mashele
M
Girardi
Jean
J
Hanson
Jean
J
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D004644:Emotions; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D010348:Patient Care Team; D011788:Quality of Life; D012380:Role; D029181:Spirituality; D011795:Surveys and Questionnaires; D016896:Treatment Outcome