Palliative Care for Quality of Life and Symptom Concerns in Lung Cancer

该计划项目申请支持一项跨学科研究计划，其中心主题与姑息治疗、生活质量(QOL)和影响21.3万美国人的肺癌轨迹的症状管理有关。通过这一计划项目，三个相互关联但又截然不同的肺癌研究项目的协同效应将得到加强。与医学研究所关于姑息治疗的报告的建议一致，我们认为，姑息治疗包括症状管理和关注患者及其家属的生活质量问题，应贯穿肺癌的整个发展轨迹。这项建议涉及NCI确定的肺癌生活质量和症状重点领域的临床研究和癌症控制研究领域。提出了三个项目：项目1是早期肺癌(N=207)，并提供了一个在疾病发展过程中整合姑息治疗的模式。项目2的重点是晚期肺癌(N=326)，这是一个存活率降低、生活质量和症状担忧较高的人群。项目3侧重于肺癌患者的家庭照顾者(N=533)。肺癌患者照顾者的负担，无论是早期还是晚期，都被证明是非常重要的，很少有研究解决这一人群中家庭照顾者的具体需求。同时进行这个项目有很大的协同作用，使我们能够接触到肺癌患者的家庭照顾者，这是一个很少研究的群体。这份方案项目建议书包括三个核心。行政核心(核心A)将开展组织调查员、评价项目目标和时间表的进展情况以及监测总体预算的工作。生物统计核心(核心B)有助于研究设计、抽样设计、力量分析，并协助最后确定方法方法，包括三个项目的统计设计。老年医学核心(核心C)将负责衡量和分析三个项目的老年结果。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。

This program project application supports a program of interdisciplinary research with central themes related to palliative care, quality of life (QOL), and symptom management across the trajectory of lung cancer affecting 213,000 Americans. The synergy across 3 interrelated but distinct research projects focused on lung cancer will be enhanced through this program project. Consistent with the recommendations of the Institute of Medicine Report on palliative care, we believe that palliative care including symptom management and attention to QOL concerns of patients and families should be addressed throughout the trajectory of lung cancer. This proposal addresses the NCI identified research areas of clinical research and cancer control in the focus areas of QOL and symptoms in lung cancer. Three projects are proposed: Project 1 is Early Stage Lung Cancer (N=207), and provides a model of integrating palliative care throughout the trajectory of disease. Project 2 focuses on Late Stage Lung Cancer (N=326), a population who have decreased survival and high QOL and symptom concerns. Project 3 focuses on Family Caregivers (N=533) of patients with lung cancer. The burden on caregivers of patients with lung cancer, both early and late stage, has been documented as very significant and few studies have addressed the specific needs of family caregivers in this population. Conducting this project simultaneously has great synergy allowing us to access family caregivers of lung cancer patients, a group rarely studied. Three cores are included in this program project proposal. The Administrative Core (Core A) will conduct the work of organizing the investigators, evaluating the progress on project goals and the timeline and monitoring the overall budget. The Biostatistics Core (Core B) contributes to study design, sampling designs, power analyses, and has assisted in finalizing the methodological approach, including statistical design for the three projects. The Geriatrics Core (Core C) will be responsible for measurement and analysis of geriatric outcomes across the three projects. 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.