EARLY PALLIATIVE CARE FOR PATIENTS WITH METASTATIC NON SMALL CELL LUNG CANCER

Raeed Khaled H.
Hamoush*

ABSTRACT

Backgr
ound: Patients with metastatic non small cell lung cancer (NSCLC) often experience significant physical
and psychological distress, yet palliative care is frequently introduced late in the disease trajectory. This study
evaluated the impact of early pallia tive care integrated with standard oncologic treatment on quality of life, mood,
healthcare utilization, and end of life care for these patients. Methods: A prospective, randomized controlled trial
was conducted with 325 newly diagnosed metastatic NSCLC pa tients. Participants were assigned to either early
palliative care plus standard oncologic care (n=163) or standard care alone (n=162). Palliative care included
monthly visits focusing on symptom management, psychosocial support, and advance care planning. Outcomes
were assessed at 12 weeks using validated tools, including the FACT L for quality of life and the PHQ 9 for
depressive symptoms. Healthcare utilization and end of life care metrics were analyzed post mortem. Results: At
12 weeks, the early pallia tive care group reported significantly improved quality of life (81.0% vs. 58.0%, p<0.001)
and lower rates of moderate to severe depression (16.0% vs. 30.2%, p=0.003). In the final 30 days of life, these
patients had fewer emergency department visits (23.9 % vs. 43.8%), hospitalizations (20.2% vs. 41.4%), and ICU
admissions (6.7% vs. 21.0%) (all p<0.001). Hospice enrollment was higher (84.0% vs. 58.0%) and occurred earlier
(74.8% vs. 38.9% enrolled >3 days before death, p<0.001). Survival was also longer in the intervention group (11.6
vs. 8.9 months). Conclusion: Early integration of palliative care for metastatic NSCLC patients significantly
enhances quality of life, reduces depressive symptoms, decreases aggressive end of life interventions, and
improves h ospice utilization. These findings support routine early palliative care as a standard component of
advanced cancer management.

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