Palliative Rehabilitation Improves Quality of Life in Newly Diagnosed Nonresectable Tumors
Patients with nonresectable tumors randomized to palliative rehabilitation also chose to participate in individual consultations and a group program with physical activity.
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Palliative rehabilitation can improve patient quality of life when included in oncology treatment soon after diagnosis, according to study results presented at the 2018 Palliative and Supportive Care in Oncology Symposium.
In this study, 301 adults with nonresectable tumors (lung, prostatic, gastrointestinal, and other cancers) diagnosed within the 8 weeks prior were randomized to 2 cohorts. One cohort was assigned to standard oncology treatment plus palliative rehabilitation options: 2 mandatory consultations plus availability of a palliative care team for 12 weeks and further options to participate in individual consultations and/or a group program with physical exercise. The other cohort was assigned to standard oncology treatment only.
Quality-of-life evaluations were based on an extended version of the EORTC QLQ-C30 questionnaire that was completed at baseline, 6 weeks, and 12 weeks. In the initial assessment patients were asked which item on the questionnaire (out of 12 possibilities) reflected their primary concern, with any improvements regarding the primary area of concern tracked and quantified over the course of the assessments.
Among the 132 patients who underwent palliative rehabilitation, 26 chose just the 2 mandatory consultations, 47 chose further individual consultations, and 59 chose to participate in the group program.
Over the 12-week period, patients in the palliative rehabilitation cohort experienced a significant improvement compared with those receiving standard care alone (P =0.047), and this was further demonstrated by sensitivity analysis (P =.005).
Palliative rehabilitation appeared to enhance quality of life for patients with nonresectable tumors who received palliative rehabilitation along with their standard oncology treatment.
The authors concluded that the parenteral opioid shortage had a significant effect on administration of opioids to patients for treatment of cancer-related pain and that this is linked with overall poorer analgesia.
Nottelmann L, Groenvold M, Petersen MA, Vejlgaard T, Jensen LH. A single-center randomized clinical trial of palliative rehabilitation versus standard care alone in patients with newly diagnosed non-resectable cancer. J Clin Oncol. 2018;36(suppl 34). Abstract 75.