PALLIATIVE CARE IMPROVE THE PROGNOSIS OF CANCER PATIENTS

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Abstract

Purpose

According to the World Health Organization (WHO), palliative care-targeted patients whose disease is not responsive to curative treatment. One sentence of ‘Palliative care is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, and such as chemotherapy or radiation therapy’ was added WHO's definition of palliative care in 2002. Early palliative care intervention is necessary for advanced cancer patients. One report shows that early palliative care intervention to metastatic non-small-cell lung cancer patients improved their prognosis. There is a possibility that the cooperation of active anti-cancer treatment and early palliative care intervention improves patient's prognosis. We made a comparative study of inpatients and outpatients of advanced cancer to clarify the appropriate time for palliative care intervention.

Subjects and methods

Two hundred one cases that had died in our department over a period of four years were divided into two groups of inpatients who experienced outpatient's service for less than 6 days (64 patients) and outpatients who experienced outpatient's service for more than 6 days (137 patients). Overall survival (OS), duration of chemotherapy and post-progression survival (PPS) in retrospect through analysis of medical records were examined respectively.

Results

OS of the outpatient group was longer than the inpatient group in all cases (19.0 months versus 6.5 months, P < 0.001). In advanced non-small-cell lung cancer with anti-cancer treatment, OS (14.5 months versus 3.0 months, P = 0.010), the duration of chemotherapy (7.0 months versus 1.5 months, P = 0.087) and PPS (7.5 months versus 1.5 months, P = 0.022) of the outpatient group were longer than those of the inpatient group.

Conclusion

In advanced non-small-cell lung cancer with anti-cancer treatment, it was suggested that the intervention of early palliative care to outpatients lead to an improvement of their prognosis.

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