title: Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial.
abstract: 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.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic Cancer Center, and Medical Social Services, Mayo Clinic, Rochester MN 55905, USA. rummans.teresa@mayo.edu
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Rummans
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Marlene H
authors.initials: MH
authors.lastname: Frost
authors.forename: John Michael
authors.initials: JM
authors.lastname: Bostwick
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Atherton
authors.forename: Mary E
authors.initials: ME
authors.lastname: Johnson
authors.forename: Gail
authors.initials: G
authors.lastname: Gamble
authors.forename: Jarrett
authors.initials: J
authors.lastname: Richardson
authors.forename: Paul
authors.initials: P
authors.lastname: Brown
authors.forename: James
authors.initials: J
authors.lastname: Martensen
authors.forename: Janis
authors.initials: J
authors.lastname: Miller
authors.forename: Katherine
authors.initials: K
authors.lastname: Piderman
authors.forename: Mashele
authors.initials: M
authors.lastname: Huschka
authors.forename: Jean
authors.initials: J
authors.lastname: Girardi
authors.forename: Jean
authors.initials: J
authors.lastname: Hanson
mesh_terms: 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