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CANCER RESPIRATOIRE

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Palliative lung radiotherapy - higher dose leads to improved survival?

LEWIS, T. S. ; KENNEDY, J. A. ; PRICE, G. J. ; MEE, T. ; WOOLF, D. K. ; BAYMAN, N. A. ; CHAN, C. ; COOTE, J. H. ; FAIVRE-FINN, C. ; HARRIS, M. A. ; HUDSON, A. M. ; PEMBERTON, L. S. ; SALEM, A. ; SHEIKH, H. Y. ; MISTRY, H. B. ; COBBEN, D. C. P.
Clinical oncology, 26/06/2020, p. 1-11

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Geographic variation in palliative care delivery among patients diagnosed with metastatic lung cancer in the USA - Medicare population-based study

HUO, Jinhai ; HONG, Young-Rock ; TURNER, Kea ; CHEN, Cheng ; GUO, Yi ; WILKIE, Diana J. ; BIAN, Jiang
Supportive care in cancer, 04/06/2020, Pagination inconnue

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Comparison of end-of-life care in people with chronic obstructive pulmonary disease or lung cancer - a systematic review

BUTLER, Stacey J ; ELLERTON, Lauren ; GERSHON, Andrea S ; GOLDSTEIN, Roger S ; BROOKS, Dina
PALLIATIVE MEDICINE, 02/06/2020, Pagination inconnue

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Relatives of deceased patients with metastatic lung cancer’s views on the achievement of treatment goals and the choice to start treatment - a structured telephone interview study

MIERAS, Adinda ; ONWUTEAKA-PHILIPSEN, Bregje D. ; BECKER-COMMISSARIS, Annemarie ; BOS, Jose C. M. ; PASMAN, H. Roeline W.
BMC palliative care, 19/06/2020, vol.19, n°1, p. 1-9

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Association of palliative care use and setting with healthcare utilization and quality of care at the end of life among patients with advanced lung cancer

VRANAS, Kelly C. ; LAPIDUS, Jodi A. ; GANZINI, Linda ; SLATORE, Christopher G. ; SULLIVAN, Donald R.
Chest, 06/2020, Pagination inconnue

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Clinical evaluation of serum tumor markers in patients with advanced-stage non-small cell lung cancer treated with palliative chemotherapy in China

ABBAS, Muhammad ; KASSIM, Said Abasse ; HABIB, Murad ; LI, Xiaoyou ; SHI, Meiqi ; WANG, Zhong-Chang ; HU, Yiqiao ; ZHU, Hai-Liang
Frontiers in oncology, 05/06/2020, vol.10, p. 1-12

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Patterns of symptom management medication receipt at end-of-life among Medicare beneficiaries with lung cancer

SAPHIRE, Maureen L. ; PRSIC, Elizabeth H. ; CANAVAN, Maureen E. ; WANG, Shi-Yi J. ; PRESLEY, Carolyn J. ; DAVIDOFF, Amy J.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 04/2020, vol.59, n°4, p. 767-777

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Palliative care in lung cancer

ARAGON, Katherine N.
Clinics in chest medicine, 06/2020, vol.41, n°2, p. 281-293

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Risk factors for esophagitis after hypofractionated palliative (chemo) radiotherapy for non-small cell lung cancer

NIEDER, Carsten ; IMINGEN, Kristian S. ; MANNSAKER, Bård ; YOBUTA, Rosalba ; HAUKLAND, Ellinor
Radiation oncology, 01/05/2020, vol.15, n°1, p. 1-6

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Thème : Médecine. Cote : eD03.01.01

RADIOTHERAPIE ; SYMPTOME DIGESTIF ; ETUDE RETROSPECTIVE ; CANCER RESPIRATOIRE

Introduction: Esophagitis influences quality of life and might cause treatment interruption and hospitalization. Previous studies of risk factors focused on curative treatment for non-small cell lung cancer (NSCLC), which often involves concomitant chemoradiation (CRT). Given the uncertainty around extrapolation of dose constraints, we analyzed risk factors in patients treated with hypofractionated palliative regimens.
Patients and methods: A retrospective review of 106 patients treated with palliative radiotherapy or CRT between 2009 and 2017 was performed. Inclusion criteria: prescribed total dose 30–54 Gy, dose per fraction 2.5–4 Gy, esophageal dose > 1 Gy. Uni- and multivariate analyses were performed in 97 eligible patients to identify predictive factors for acute esophagitis grade = 1 (CTCAE 5.0).
Results: Forty percent of patients were treated with 15 fractions of 2.8 Gy (42 Gy) and 28% also received chemotherapy according to the CONRAD study regimen (induction and concomitant Carboplatin/Vinorelbine) published by the Norwegian Lung Cancer Group. Thirty-four percent were treated with 10 fractions of 3 Gy. Stage IV NSCLC was present in 47%. Esophagus Dmax was 39 Gy (population median) and Dmean 15 Gy. Overall 31% of patients developed esophagitis (26% grade 2–3, no grade 4–5). Several dosimetric parameters correlated with the risk of esophagitis (Dmax, Dmean, D5cc, V20, V30, V35, V40). Dmax outperformed other dosimetric variables in multivariate analysis. Furthermore, concomitant chemotherapy significantly increased the risk of esophagitis, while oral steroid medication reduced it. In patients with Dmax =40 Gy a reduced Dmean (=20 Gy) was beneficial.
Conclusion: In order to reduce esophagitis after hypofractionated palliative treatment lower doses than those recommended in curative NSCLC settings are preferable. Besides esophageal dose, CRT is the main risk factor for esophagitis. Additional work is needed to confirm that steroids are able to modify the risk (or to rule out confounding effects of baseline variables not included in our database).

Origine : PubMed

Implementing "goals of care" discussion and palliative care referral for patients with advanced lung cancer - an outpatient-based pilot project: bringing forward the conversation

CONDUIT, Ciara ; THOMPSON, Michael ; THOMAS, Robyn ; NOTT, Louise ; WUTTKE, Melanie
Internal medicine journal, 23/03/2020, Pagination inconnue

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Sleep quality, anxiety and depression in advanced lung cancer - patients and caregivers

HE, Yuan ; SUN, Li-Yue ; PENG, Kun-Wei ; LUO, Man-Jun ; DENG, Ling ; TANG, Tao ; YOU, Chang-Xuan
BMJ supportive and palliative care, 06/04/2020, Pagination inconnue

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Thème : Psychologie, psychanalyse.

SOMMEIL ; ANXIETE ; DEPRESSION ; CANCER RESPIRATOIRE ; CHINE

Objective: To investigate the clinical implications of sleep quality, anxiety and depression in patients with advanced lung cancer (LC) and their family caregivers (FCs).
Methods: A total of 98 patients with advanced LC and their FCs (n=98) were recruited from the Oncology Department in Nanfang Hospital. The Pittsburgh Sleep Quality Index (PSQI), consisting of seven components that evaluate subjective sleep quality, sleep latency, duration of sleep, sleep efficiency, sleep disturbances, sleep medication usage and daytime dysfunction, was used to assess sleep quality. Using the tool of Zung Self-rating Anxiety Scale (SAS) and Zung Self-rating Depression Scale (SDS), we tested the patients’ status of anxiety and depression, respectively.
Results: The prevalences of poor sleep quality, anxiety and depression in patients were 56.1%, 48.9% and 56.1%, respectively, while those in FCs were 16.3%, 32.6% and 25.5%, respectively. Patients had higher PSQI, SAS and SDS scores than did FCs (p<0.05). Significant correlations were found between the patients’ and FCs’ scores of PSQI/SAS/SDS (p<0.05). Multivariate Cox regression analyses indicated that sleep disturbances in patients (HR 0.413, 95% CI 0.21 to 0.80, p=0.01) and the global PSQI score of FCs (HR 0.31, 95% CI 0.14 to 0.71, p=0.00) were independent risk factors for patients’ first-line progression-free survival (PFS). Moreover, patients’ sleep latency (HR 2.329, 95% CI 1.36 to 3.96, p=0.00) and epidermal growth factor receptor mutations (HR 1.953, 95% CI 1.12 to 3.38, p=0.01) were significant prognostic factors for their overall survival (OS).
Conclusions: We demonstrated that presence of sleep disturbances in patients with advanced LC and the global PSQI Score of their FCs may be risk predictors for patients’ poor first-line PFS. Patients’ sleep latency was a potential risk factor for their OS.

Origine : DOI.org (Crossref

ABRAVAN, Azadeh ; EIDE, Hanne Astrid ; HELLAND, Aslaug ; MALINEN, Eirik
Clinical and translational radiation oncology, 05/2020, vol.22, p. 15-21

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Thème : Médecine. Cote : eD03.02

RADIOTHERAPIE ; CANCER RESPIRATOIRE ; THERAPEUTIQUE ANTI CANCEREUSE ; HEMATOLOGIE

Background: Lymphopenia during radiotherapy (RT) may have an adverse effect on treatment outcome. The aim of this study is to investigate associations between lymphopenia and RT parameters in patients with advanced lung cancer. Moreover, to investigate the prognostic role of lymphopenia, blood protein levels, and treatment and patient-related factors.
Material and Methods: Sixty-two advanced stage non-small cell lung cancer (NSCLC) patients were retrospectively analyzed. Blood counts were available prior to, during, and after RT (3Gyx10). For each patient, a thoracic volume of interest (VOI) -including thoracic soft tissue and trabecular bone- was obtained by applying a CT window of -500 to 1200 HU in the planning CT. Dose parameters from thoracic VOI and other regions including lungs and vertebrae were calculated. Association between risk of lymphopenia = G3 (lymphocytes at nadir according to CTCAE v4.0) and therapeutic parameters was investigated using Logistic regression. Relationships between overall survival (OS) and RT dose parameters, baseline blood counts and protein levels, and clinical factors were evaluated using Log-rank and Cox models.
Result: Mean thoracic RT dose (odds ratio [OR] 1.67; p = 0.04), baseline lymphocytes (OR 0.65; p = 0.01), and corticosteroids use (OR 6.07; p = 0.02) were significantly associated with increased risk of lymphopenia = G3 in multivariable analysis. Worse OS was associated with high mean thoracic RT dose, high CRP/Albumin, large tumor volume and corticosteroids use (p < 0.05, univariate analysis), but not with lymphopenia = G3. CRP/Albumin ratio > 0.12 (hazard ratio [HR] 2.28, p = 0.03) and corticosteroid use (HR 2.52, p = 0.01) were independently associated with worse OS.
Conclusion: High thoracic RT dose gave a higher risk of lymphopenia = G3; hence limiting dose volume to the thorax may be valuable in preventing severe lymphopenia for patients receiving palliative fractionated RT. Still, lymphopenia = G3 was not associated with worse OS. however, high baseline CRP/Albumin was associated with poorer OS and may carry important information as a prognostic factor of OS in advanced NSCLC receiving palliative RT.

Origine : PubMed

Regional variation in hospital care at the end-of-life of Dutch patients with lung cancer exists and is not correlated with primary and long-term care

DE MAN, Yvonne ; GROENEWOUD, Stef ; OOSTERVELD-VLUG, Mariska G. ; BROM, Linda ; ONWUTEAKA-PHILIPSEN, Bregje D. ; WESTERT, Gert P. ; ATSMA, Femke
International journal for quality in health care, 18/03/2020, p. 1-6

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Impact of length of hospice on spending and utilization among medicare beneficiaries with lung cancer

KALIDINDI, Yamini ; JUNG, Jeah ; SEGEL, Joel ; LESLIE, Douglas
The American journal of hospice and palliative care, 03/03/2020, Pagination inconnue

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Concurrent hospice care and cancer-directed treatment for advanced lung cancer and receipt of aggressive care at the end of life in the Veteran's Health Administration

PRESLEY, Carolyn J. ; HAN, Ling ; O'LEARY, John R. ; ZHU, Weiwei ; CORNEAU, Emily ; CHAO, Herta ; SHAMAS, Tracy ; ROSE, Michal ; LORENZ, Karl A. ; LEVY, Cari R. ; MOR, Vincent ; GROSS, Cary P.
JOURNAL OF PALLIATIVE MEDICINE, 02/03/2020, Pagination inconnue

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Performance status and end-of-life care among adults with non-small cell lung cancer receiving immune checkpoint inhibitors

PETRILLO, Laura A. ; EL-JAWAHRI, Areej ; NIPP, Ryan D. ; LICHTENSTEIN, Morgan R. L. ; DURBIN, Sienna M. ; REYNOLDS, Kerry L. ; GREER, Joseph A. ; TEMEL, Jennifer S. ; GAINOR, Justin F.
Cancer, 06/03/2020, Pagination inconnue

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Death anxiety in patients with metastatic non-small cell lung cancer with and without brain metastases

EGGEN, Annemarie C. ; REYNERS, Anna K. L. ; SHEN, Gerald ; BOSMA, Ingeborg ; JALVING, Mathilde ; LEIGHL, Natasha B. ; LIU, Geoffrey ; RICHARD, Nadine M. ; MAH, Kenneth ; SHULTZ, David B. ; EDELSTEIN, Kim ; RODIN, Gary
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 04/03/2020, Pagination inconnue

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Thème : Psychologie, psychanalyse.

CANCER RESPIRATOIRE ; METASTASE CEREBRALE ; MORT ; ANXIETE ; REPRESENTATION MORT

CONTEXT: Death anxiety is common in patients with metastatic cancer, but its relationship to brain metastases and cognitive decline is unknown. Early identification of death anxiety and its determinants allows proactive interventions to be offered to those in need.
OBJECTIVE: To identify psychological, physical and disease-related (including brain metastases, cognitive impairment) factors associated with death anxiety in mNSCLC patients.
METHODS: A cross-sectional pilot study with mNSCLC outpatients completing standardized neuropsychological tests and validated questionnaires measuring death anxiety, cognitive concerns, illness intrusiveness, depression, demoralization, self-esteem, and common cancer symptoms. We constructed a composite for objective cognitive function (mean neuropsychological tests z-scores).
RESULTS: Study measures were completed by 78 patients (50% female, median age: 62 years (range:37-82)). Median time since mNSCLC diagnosis was 11 months (range:0-89); 53% had brain metastases. At least moderate death anxiety was reported by 43% (n=33). Objective cognitive impairment was present in 41% (n=32) and perceived cognitive impairment in 27% (n=21). Death anxiety, objective, and perceived cognitive impairment did not significantly differ between patients with and without brain metastases. In univariate analysis, death anxiety was associated with demoralization, depression, self-esteem, illness intrusiveness, common physical cancer symptoms, and perceived cognitive impairment. In multivariate analysis, demoralization (p<0.001) and illness intrusiveness (p=0.001) were associated with death anxiety.
CONCLUSION: Death anxiety and brain metastases are common in mNSCLC patients, but not necessarily linked. The association of death anxiety with both demoralization and illness intrusiveness highlights the importance of integrated psychological and symptom management. Further research is needed on the psychological impact of brain metastases.

Origine : PubMed

Retrospective prognostic study of death at home or hospice versus at a hospital among patients with advanced non-small cell lung cancer

HAMAMOTO, Yoichiro ; IBE, Tatsuya ; KODAMA, Hiroaki ; MOURI, Atsuto ; MINESHITA, Masamichi
The American journal of hospice and palliative care, 02/2020, vol.37, n°2, p. 129-135

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Implementation of the milestones communication approach for patients with limited prognosis - evaluation of intervention fidelity

BOSSERT, Jasmin ; WENSING, Michel ; THOMAS, Michael ; VILLALOBOS, Matthias ; JUNG, Corinna ; SIEGLE, Anja ; HAGELSKAMP, Laura ; DEIS, Nicole ; JUNGER, Jana ; KRUG, Katja
BMC palliative care, 18/02/2020, vol.19, n°1, p. 1-10

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Intensity of care, expenditure, place and cause of death people with lung cancer in the year before their death - a French population based study

TANGUY-MELAC, Audrey ; DENIS, Pierre ; PESTEL, Laurence ; FAGOT-CAMPAGNA, Anne ; GASTALDI-MENAGER, Christelle ; TUPPIN, Philippe
Bulletin du cancer, 03/2020, vol.107, n°3, p. 308-321

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