Assessment of palliative care for advanced non-small-cell lung cancer in France: a prospective observational multicenter study (GFPC 0804 study).
BACKGROUND
Few studies assessed, in real life, symptoms, specific interventions and factors influencing palliative care (PC) initiation for patients with advanced non-small-cell lung cancer (NSCLC). The objective of this study was to examine, in a prospective cohort of advanced NSCLC patients, PC use and factors associated with early (≤3 months after diagnosis) PC initiation.


METHODS
It was an observational multicenter study. Each center included 10 consecutive patients with PC initiation.


RESULTS
514 patients were enrolled by 39 centers (age: 62.3 ± 10.7 years, performance status: 0/1; 68.6% cases). At baseline, the most frequent symptoms concerned pain (43.6%), malnutrition (37%) and psychological disorders (25.3%). Specific interventions were infrequent for pain control and malnutrition, but were more numerous for psychological and social problems and terminal care. Median time between diagnosis and PC initiation was 35 [13-84] days, median PC duration was 4.2 [0.6-9.3] months. Median overall survival was 8.6 [6.6-10.7] months; median survival after PC initiation was 3.6 [3.2-4.5] months. In multivariate analysis, only PS ≥2 was linked to early PC.


CONCLUSIONS
This study showed that early PC initiation is not a standard for patients with advanced NSCLC.
Chest Department of Limoges, France. Electronic address: alain.vergnenegre@unilim.fr.
Alain
A
Vergnenègre
Stéphane
S
Hominal
Achille Edem
AE
Tchalla
Henri
H
Bérard
Isabelle
I
Monnet
Gislaine
G
Fraboulet
Nathalie
N
Baize
Clarisse
C
Audigier-Valette
Gilles
G
Robinet
Gérard
G
Oliviero
Hervé
H
Le Caer
Pascal
P
Thomas
Laurence
L
Gérinière
Bénédicte
B
Mastroianni
Christos
C
Chouaïd
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011379:Prognosis; D011446:Prospective Studies
Economics; Non-small-cell lung cancer; Observational study; Palliative care; Quality of care