Late Stage Lung Cancer

项目总结(海上说明)： 项目2：晚期肺癌在一个与姑息治疗、生活质量(QOL)和症状管理相关的中心主题的项目中，专注于Illb-IV期不能切除的肺癌。这个项目的重点是晚期肺癌，这是一个存活率下降，生活质量和症状关注较高的人群。研究的目的是： 目的：测试姑息性护理干预(PCI)对晚期(Illb-IV期)非小细胞肺癌患者整体生活质量和心理困扰的影响，并与接受常规护理的患者进行比较。 目的：比较晚期非小细胞肺癌经皮冠状动脉介入治疗组与常规护理组的症状控制情况。 目的：比较经皮冠状动脉介入治疗组与常规护理组的老年评估结果(OARS日常生活能力量表、MOS日常生活活动能力量表、MOS社交活动受限量表、医院焦虑和抑郁量表评分、Karnofsky表现量表)。 目的4：与常规护理组比较，测试经皮冠状动脉介入治疗对资源利用的影响。 目的5：确定在12周的主要终点时，与社会人口学特征、治疗因素和老年评估预测因素相关的从经皮冠状动脉介入治疗中获益最多的患者亚组。 该项目将采用两组、预期顺序、准实验、串联登记设计(N=326)，其中常规护理组在第一阶段累积并跟随，干预组在第二阶段累积并跟随。 拟议的介入治疗通过一个跨学科团队的协作，将治疗前评估和目标设定结合在一起。姑息治疗干预是基于2005年至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。 鉴于大量被诊断为肺癌的人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.