Early integration of palliative care facilitates the discontinuation of anticancer treatment in women with advanced breast or gynecologic cancers

Author(s)

Rugno, Fernanda Capella ^{[1, 2]} ; Ribeiro Paiva, Bianca Sakamoto ^{[1, 3]} ; Paiva, Carlos Eduardo ^{[1, 3, 4]}

Affiliation

^[1] Pio XII Fdn, Barretos Canc Hosp, Hlth Related Qual Life Res Grp GEQual, Barretos, SP - Brazil

^[2] Pio XII Fdn, Barretos Canc Hosp, Palliat Care Unit, Barretos, SP - Brazil

^[3] Pio XII Fdn, Barretos Canc Hosp, NAP, Ctr Res Support, Barretos, SP - Brazil

^[4] Pio XII Fdn, Barretos Canc Hosp, Dept Clin Oncol, Barretos, SP - Brazil

• Document type: Journal article
• Source: GYNECOLOGIC ONCOLOGY; v. 135, n. 2, p. 249-254, NOV 2014.
• Web of Science Citations: 30

Abstract

Objectives. To evaluate some health indicators in women with advanced breast or gynecological cancers (ABGCs) after discontinuation of active cancer treatment in function of the model of care received. Methods. This prospective study included patients who were discontinuing anticancer treatment to be followed up only with palliative care (PC). Patients who had been evaluated at least once in PC were categorized as the integrated care model (ICM); those who had not been consulted by the PC team before, as the traditional care model (TCM). Data were analyzed using chi-square, Mann-Whitney, Kaplan-Meier, and Cox regression model. Results. Among the 87 patients included in the study, 37 (42.5%) had been previously evaluated by the PC team (ICM). Patients who were followed up under an ICM exhibited better QoL (global health, p = 0.02; emotional functioning, p = 0.03; social functioning, p = 0.01; insomnia, p = 0.02) and less depression (p = 0.01). The communication process had no issues in 73% of cases from the ICM group compared with 42% of cases from the TCM group (p = 0.004). Patients who were not previously evaluated in PC received more chemotherapy in the last 6 weeks of life compared to those who had already been evaluated (40% versus 5.9%, p = 0.001). Early evaluation in PC was one of the independent prognostic factors of overall survival. Conclusion. When followed up concurrently by a PC and clinical oncology team, patients reported better QoL and less depression, received less chemotherapy within the last 6 weeks of life and survived longer than those followed up under a TCM. (C) 2014 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 12/03793-9 - Evaluation of the transition phase to exclusive palliative care in patients with breast and gynecological advanced cancers
• Grantee: Fernanda Capella Rugno
• Support Opportunities: Scholarships in Brazil - Master