Timing of palliative care referral and symptom burden in phase 1 cancer patients: a retrospective cohort study. Cancer 2010 Sep 15;116(18):4402-9
Date
06/22/2010Pubmed ID
20564164Pubmed Central ID
PMC2936661DOI
10.1002/cncr.25389Scopus ID
2-s2.0-77957367729 (requires institutional sign-in at Scopus site) 50 CitationsAbstract
BACKGROUND: Phase 1 trials offer patients with advanced cancer the opportunity to pursue life-prolonging cancer treatments. In the current study, the timing of referral and symptom burden between patients referred to palliative care by phase 1 oncologists and those referred by non-phase 1 oncologists were compared.
METHODS: All 57 patients with advanced solid tumors who were referred by phase 1 oncologists to the palliative care outpatient clinic at The University of Texas M. D. Anderson Cancer Center (MDACC) between 2007 and 2008 were included. The comparison cohort was comprised of 114 non-phase 1 patients who were stratified by age, sex, and cancer diagnosis in a 1:2 ratio. Information regarding patient characteristics, Edmonton Symptom Assessment Scale (ESAS), timing of referral, and survival was retrieved.
RESULTS: Both cohorts had the following matched characteristics: average age of 57 years, with 44% of the patients being female and 47% having gastrointestinal cancers. At the time of palliative care consultation, patients referred by phase 1 oncologists were more likely than patients referred by non-phase 1 oncologists to have a better performance status (Eastern Cooperative Oncology Group 0-1: 61% vs 36% [P = .003). The ESAS was not significantly different with the exception of better well-being in the phase 1 cohort (mean, 4.5 vs 5.5; P = .03). No difference was found for the duration between registration at MDACC and palliative care consultation (13 months vs 11 months; P = .41) and overall survival from the time of palliative care consultation (5 months vs 4 months; P = .69).
CONCLUSIONS: Outpatients referred to palliative care by phase 1 oncologists were found to have a better performance status but similar symptom burden compared with patients referred by non-phase 1 oncologists. Patients with phase 1 involvement did not appear to have delayed palliative care referral compared with non-phase 1 patients. The results of the current study support the development of a simultaneous care model.
Author List
Hui D, Parsons H, Nguyen L, Palla SL, Yennurajalingam S, Kurzrock R, Bruera EAuthor
Razelle Kurzrock MD Center Associate Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Clinical Trials, Phase I as TopicCohort Studies
Depression
Fatigue
Female
Humans
Male
Middle Aged
Neoplasms
Pain
Palliative Care
Quality of Health Care
Referral and Consultation
Retrospective Studies
Survival Analysis
Time Factors
