Late Stage Lung Cancer

项目概要（海上指示）： 项目二：晚期肺癌的重点是IIIb-IV期不可切除的肺癌，其中心主题与姑息治疗，生活质量（QOL）和症状管理有关。该项目的重点是晚期肺癌，这是一个生存率下降，生活质量和症状问题高的人群。研究的目的是： 目标1：检测姑息治疗干预（PCI）对晚期（IIIb-IV期）不可切除NSCLC患者的总体QOL和心理困扰的影响，并与接受常规治疗的患者进行比较。 目的2：比较PCI组与常规治疗组晚期NSCLC患者的症状控制情况。 目标3：比较PCI组与常规护理组的老年评估结果（OARS工具性日常生活活动、MOS日常生活活动、MOS社会活动限制量表、医院焦虑和抑郁量表评分以及Karnofsky行为量表）。 目的4：与常规护理组相比，测试PCI对资源使用的影响。 目标5：在12周主要终点时，根据社会人口学特征、治疗因素和老年评估预测因素，确定从PCI中获益最多的患者亚组。 本项目将采用两组、前瞻性序贯、准实验、串联入组设计（N=326），其中常规治疗组在第1阶段进行招募和随访，干预组在第2阶段进行招募和随访。 通过跨学科团队的合作，拟议的PCI干预结合了治疗前评估和目标设定。姑息治疗干预措施是基于2005-2007年由调查人员完成的试点工作，记录肺癌患者的需求并测试干预措施。 鉴于被诊断患有肺癌的人数众多以及相关的个人和社会成本，该项目对公共卫生具有重大意义。

PROJECT SUMMARY (Sea instructions): Project 2: Late Stage Lung Cancer focuses on Stages Illb-IV unresectable lung cancer within a program project with central themes related to palliative care, quality of life (QOL), and symptom management. This project focuses on Late Stage Lung Cancer, a population who have decreased survival and high QOL and symptom concerns. The aims of the research are: Aim1: Test the effects of the Palliative Care Intervention (PCI) on overall QOL and psychological distress for patients with Late (Stage Illb-IV) non-resectable NSCLC compared to a group receiving usual care. Aim 2: Compare symptom control in the PCI group versus the usual care group in Late Stage NSCLC. Aim 3: Compare geriatric assessment outcomes (OARS Instrumental Activities of Daily Living, MOS Activities of Daily Living, MOS Social Activities Limitation Scale, Hospital Anxiety and Depression Scale scores, and the Karnofsky Performance Scale) in the PCI group versus the usual care group. Aim 4: Test the effects of the PCI on resource use as compared to the usual care group. Aim 5: Identify subgroups of patients who benefit most from the PCI in relation to sociodemographic characteristics, treatment factors, and geriatric assessment predictors at the 12 week primary end point. A two-group, prospective sequential, quasi-experimental, tandem enrollment design (N=326) will be used for this project, in which the usual care group is accrued and followed during Phase 1 and the intervention group is accrued and followed during Phase 2. The proposed PCI intervention combines pre-treatment assessment and goal setting through the collaboration of an interdisciplinary team. The Palliative Care Intervention is based on pilot work completed from 2005-2007 by the investigators documenting needs of lung cancer patients and testing the intervention. This project has great significance to public health given the significant numbers of people diagnosed with lung cancer and the associated individual and societal costs.