Effect Of Pain Care On Quality Of Life And Survival In Patients With Advanced Non-small-cell Lung Cancer

Background and objective：Based on a Retrospective analysis of the clinical dataof144patients with newly diagnosed advanced non-small-cell lung cancer (NSCLC)，that all suffering tumor associated pain．All the patients received standard chemotherapysimultaneously with or without pain care．We study the effect of pain care on quality oflife and survival of the patients，aimed to warn that pain care also is important．Methods：Through the electronic medical record query system，Collected144patients newly diagnosed and admitted to oncology department first affiliated hospitalof Dalian medical university from January1，2011to March1，2013．Confirmed byclinical，imaging and pathological to be stage III，IV non-small cell lung cancer patientswithout brain metastases and with tumor associated pain (numeric rating scale score of4or more points)．ECOG (Eastern Cooperative Oncology Group) scale≤2．All patientsreceived Standard chemotherapy not combined with radiotherapy for local Lesions asthe first line treatment．According to whether received pain care，the patients weredivided into two groups．analyzing the clinical features of two groupsResults：1. Clinical biological characteristics：The median age of the144patients was59.05±8.35years，male patients were78cases，and female patients were66cases（theratio is1.18;14cases were stage III and130cases were stage IV．Adenocarcinoma87cases，squamous carcinoma41cases other16cases．group of pain care integratedwith standard oncology care(group A) and group of standard onco logy care alone(group B) had good balance in Age，gender，pathological type，stage and metastatic site，painsite，pain degree before treatment（p＞0.05）．2. Change of quality of life：1) Onbaseline the proportionof the cases scored≤1and2were similar between twogroups respectively．There was no statistically significant difference（P=0.263＞0.05）．2) After treatment ECOG score of two groups both significantly declined from2to1or0compared with base line，34cases in group A and27cases in group B．Theirdifference showed statistic significant（P=0.000＜0.05）．3) The ECOG score declined cases were more in group A than in group B．theirdifference showed statistic significant（P=0.002＜0.05）．3．Two groups accepted different kinds regimen of anti-tumor treatment werecompared with interval time：The second-line treatment in group A had46case，theaverage interval time between first-and second-line treatment was122.54days；thesecond-line treatment in group B had37cases，the average interval time between thefirst-and second-line treatment was125.54days；The average interval time has nostatistically significant (p=0.868>0.05)．The third-line treatment in group A had15cases，the average interval time between the second-and third-line treatment was83.47days；the third-line treatment in group B had12cases，the average interval time betweenthe second-and third-line treatment was104.33days．The average interval time has nostatistically significant (p=0.522>0.05)．4．Compare of Average cycles of chemotherapy in two groups：Different cycles of chemotherapy all patients received ranged from2up to20．Average cycles of chemotherapy was6.37in group A and5.16in group B．theirdifference showed statistic significant（P=0.013＜0.05）5．Survival analysis：1) Survival analysis in two groups：Until March1，2014，the survival of all patientswas from2to30months．The average overall survival was12.32months，mediansurvival time was11.50months and1year survival rate was46.5%．The average overallsurvival of group A was13.03months，median survival time was12months；The average overall survival of group B was11.62months，median survival time was10.50months，their difference showed no statistic significant．1-year survival rate was48.6%in group A and37.8%in group B，Theχ2inspection，χ2=1.960，P=0.194>0.05，There was no statistically significant difference．But the average overall survival， themedian survival time of group A，1year survival rate is higher．2) Survival analysis of cases suffering chest pain：Among97cases suffering chestpain，53cases in group A(group C) and44cases in group B(group D)．The averageoverall survival was11.95months，median survival time was11.50months．The averageoverall survival of group C was12.88months，median survival time was11.50months；The average overall survival of group D was10.75months，median survival time was10.50months，Their difference showed statistic significant（P=0.040＜0.05）．1-yearsurvival rate was45.3%in group C and34.1%in group D，There was no statisticallysignificant difference（P=0.263>0.05）．Conclusion：Pain is one of the common symptoms of advanced NSCLC；Pain carecan improve quality of life in patients with NSCLC suffering tumor associated pain；Pain care can prolong survival in patients with NSCLC suffering tumor associated pain．...