Early Integration of Interdisciplinary Supportive Care Leads to Improved Quality of Life for Patients with NSCLC

Supportive care during the cancer journey has been demonstrated to lead to improvement in patients’ quality of life (QOL) and survival.¹ It can also assist in accurate diagnosis and disease management.¹ The Multinational Association of Supportive Care in Cancer has defined supportive care as “the prevention and management of the adverse effects of cancer and its treatment. This includes management of physical and psychological symptoms and side effects across the continuum of the cancer experience from diagnosis through treatment to post-treatment care. Enhancing rehabilitation, secondary cancer prevention, survivorship, and end-of-life care are integral to supportive care.”¹ For patients with non–small-cell lung cancer (NSCLC), which is a leading cause of cancer-related deaths, supportive care at initial diagnosis is important to improve patient prognosis.²

Chen and colleagues presented the results of a randomized controlled trial on early integration of interdisciplinary supportive care for patients with NSCLC at the European Society for Medical Oncology Congress 2021. At study start, 60 patients with newly diagnosed NSCLC were randomly assigned to 1 of 2 groups: those receiving early interdisciplinary supportive care (ESC) along with standard oncological care (SC) or those who received SC alone. The study intent was to assess the QOL, psychological state, cancer pain, and nutritional status of the patients. QOL and psychological state were assessed at baseline and then again at 6 months using the Patient Health Questionnaire-9 (PHQ-9), the Functional Assessment of Cancer Therapy-Lung (FACT-L), and the Hospital Anxiety and Depression Scale (HADS). To assess nutritional status and cancer pain, the Numerical Rating Scale and Patient-Generated Subjective Global Assessment were used.

At 6 months, compliance was 77% for the ESC/SC group and 73% for the SC group. Patients in the ESC/SC group were found to have a better QOL, with a FACT-L scale mean score of 122.3 compared with a score of 113.0 for the SC group. Anxiety and depression were also lower in the ESC group. The ESC/SC group had a mean HADS anxiety subscale of 1.13 and a mean HADS depression subscale of 0.65. For the SC group, the HADS anxiety subscale was 2.86 and the mean HADS depression subscale was 3.56. When the PHQ-9 results were examined, 100% of the ESC/SC group were free of depression. In the SC group, 55.5% of the patients had mild depression, with 45.5% being free of depression. Moderate malnutrition was found in 60.9% of the ESC/SC group. In the SC group, 50.0% of patients had moderate malnutrition and 40.9% had severe malnutrition. The remainder of each group experienced mild malnutrition.

Early integration of interdisciplinary supportive care in this study population led to significant QOL, mood, and nutritional status improvement.

Source

Chen M, Yu H, Yu H, et al. Early interdisciplinary supportive care in patients with non-small cell lung cancer: A randomised controlled trial. Ann Oncol. 2021;32(suppl_5):S1080.

References

1. Berman R, Davies A, Cooksley T, et al. Supportive care: an indispensable component of modern oncology. Clin Oncol (R Coll Radiol). 2020;32:781-788.
2. Lai YH, Chen WN, Hsu TC, et al. Overall survival prediction of non-small cell lung cancer by integrating microarray and clinical data with deep learning. Sci Rep. 2020;10:4679.