The role of palliative care in the lung cancer patient: can we improve quality while limiting futile care?
OBJECTIVE
Lung cancer is the leading cause of cancer death worldwide, and is diagnosed in the advanced stage in 70% of patients. This study will summarize the most up-to-date strategies in supportive care for patients with metastatic lung cancer.


RESULTS
Two recent systematic reviews concluded that longer-course radiation treatment offers a survival and symptom benefit over short-course treatment in patients with good performance status. Whereas several meta-analyses have demonstrated the benefit of palliative chemotherapy for quality of life and survival, the optimal drug combination and number of courses remain under study, and proper stratification of patients is essential. Clinical practice guidelines are available for evidence-based management of symptoms common in patients with lung cancer. Early integration of specialized palliative care shows promise as a means of improving patient care and limiting unnecessary treatment.


CONCLUSIONS
Supportive care for the patient with advanced lung cancer should involve consideration and discussion of all therapeutic options that could provide benefit. Depending on the clinical situation, these could include chemotherapy or radiation, and should always include appropriate symptom management and family support. Research incorporating symptom and quality-of-life measures is challenging, but is also essential to inform excellent supportive care.
Division of Medical Oncology and Haematology, University of Toronto, Toronto, Canada.
Orit C
OC
Freedman
Camilla
C
Zimmermann
D023381:Endpoint Determination; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D012944:Social Support