%0 Journal Article
%T Palliative Radiotherapy with or without Additional Care by a Multidisciplinary Palliative Care Team: A Retrospective Comparison
%A Carsten Nieder
%A Kent Angelo
%A Astrid Dalhaug
%A Adam Pawinski
%A Gro Aandahl
%A Ellinor Haukland
%A Kirsten Englj£¿hringer
%J ISRN Oncology
%D 2014
%R 10.1155/2014/715396
%X Purpose. To analyze pattern of care and survival after palliative radiotherapy (RT) in patients managed exclusively by regular oncology staff or a multidisciplinary palliative care team (MPCT) in addition. Methods. Retrospective analysis of 522 RT courses. Comparison of Two Groups: MPCT versus none. Results. We analyzed 140 RT courses (27%) with MPCT care and 382 without it. The following statistically significant differences were observed: 33% of female patients had MPCT care versus only 23% of male patients and 37% of patients <65 years had MPCT care versus only 22% of older patients. MPCT patients were more likely to have poor performance status and liver metastases. In the MPCT group steroid and opioid use was significantly more common. Dose-fractionation regimens were similar. Median survival was significantly shorter in the MPCT group, 3.9 versus 6.9 months. In multivariate analysis, MPCT care was not associated with survival. Adjusted for confounders, MPCT care reduced the likelihood of incomplete RT by 33%, . Conclusions. Patterns of referral and care differed, for example, regarding age and medication use. It seems possible that MPCT care reduces likelihood of incomplete RT. Therefore, the impact of MPCT care on symptom control should be investigated and objective referral criteria should be developed. 1. Background Patients with cancer referred to palliative radiotherapy often experience considerable burden from disease-related symptoms such as pain, bleeding, or neurological deficits, which may improve after successful completion of treatment [1]. Due to high rates of symptom improvement, radiotherapy has become a mainstay in multidisciplinary care for patients with incurable cancer. However, large variations exist in radiotherapy regimens, supportive therapy, resource utilization, involvement of other medical disciplines and professions, and care setting [2]. Several studies have shown that patients with noncurable metastatic cancer might receive too aggressive and long-standing treatment during the last months of life [3¨C7]. The focus on optimal supportive care may be lost or prioritized too late. Recently, a randomized trial of early palliative care for patients with newly diagnosed metastatic non-small cell lung cancer (NSCLC), which recruited patients in the time period between 2006 and 2009, was published [8, 9]. This single institution trial included 151 patients. Early palliative care integrated with standard oncology care was compared to standard oncology care alone. Patients assigned to the experimental arm consulted with a member
%U http://www.hindawi.com/journals/isrn.oncology/2014/715396/