No additional quality of life benefits of early palliative care in recently diagnosed malignant pleural mesothelioma
The introduction of early specialist palliative care for patients recently diagnosed with malignant pleural mesothelioma (MPM) has no impact on the quality of life (QOL) scores, reveals a research presented by Professor Fraser Brims, of Curtin University Australia, at the recent International Association for the Study of Lung Cancer (IASLC) 18th
World Conference on Lung Cancer (WCLC), held recently in Yokohama, Japan.
The RESPECT-MESO (Regular Early SPECialisT palliative care in malignant pleural MESOthelioma) trial is a multi-centre non-blinded randomized controlled trial to determine the impact of early specialist palliative care on quality of life on malignant mesothelioma. A total of 174 patients were randomized to receive either early palliative care plus standard care or just standard care alone. The group receiving early specialist care had a visit from specialists every 4 weeks throughout the course of the study.
Patients in the study had a median age of 72.6 years and 139 (79.9 percent) were male. At week 24, 30 participants had died and the overall median survival was 52 weeks.
Researchers utilized the EORTC QLQ-C30 questionnaire (for quality of life determination) and the General Health Questionnaire (GHQ-12) for anxiety or depression measurements. The primary outcome being monitored was the change in EORTC QLQ-C30’s QOL status at 12 weeks post randomization. At 12 weeks, there was no significant difference in quality of life between the specialist treated and standard treated groups.
Brims said it was evident from the trial results that there is no role for routine early referral to palliative care, regardless of symptoms, as there was no impact on quality of life or mood in recently diagnosed malignant pleural mesothelioma patients in the intervention group. As the study doesn’t provide clear results on what the optimal timing for referral is, that decision should continue to be based on clinicians’ judgement. Brims noted that future research into this question may be useful to review this practice to ensure optimal use of healthcare resources.