Personalized Palliative and Survivorship Care for Patients With Metastatic Cancer Treated With Radiation Therapy

While the benefits of early palliative care for patients with metastatic cancer are well established, cancer survivorship remains inadequately integrated into the care of patients with distant metastases. Moreover, the optimal model of care delivery is poorly defined. A prognostic model previously developed and validated at Good Samaritan University Hospital identified four groups of patients with metastatic solid tumor malignancy having very favorable, favorable, standard or unfavorable prognoses with median survival of 31, 14, 4 and 1 month, respectively. This framework holds promise for the personalized delivery of supportive, palliative and survivorship care services in the context of radiation therapy. We review the published literature providing the rationale for a novel multidisciplinary care model where the radiation oncology Clinical Nurse Specialist identifies and coordinates interventions to address unmet physical and emotional issues faced by survivors with metastatic cancer with the goal of improving quality of life and overall survival

Correction: Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology

<p>Correction: Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology</p

Cox multivariable analysis of predictors of overall survival.

<p>Cox multivariable analysis of predictors of overall survival.</p

Overall Survival Stratified by Risk Score.

<p>Very low risk patients have a risk score of 0 to 1. Low risk patients have a risk score of 1.5 to 2. Intermediate risk patients have a risk score of 2.5 to 3.5. High risk patinets have a risk score of ≥4. Patients receive 1 point for serum albumin <2.4, ECOG performance status 2, ≥6 active tumors or primary site other than breast, kidney or prostate. Patients receive 2 points for ECOG performance status 3 to 4 and 0.5 points for serum albumin 2.4 to 3.3.</p

Linear regression of predictors of 6-month survival.

<p>Linear regression of predictors of 6-month survival.</p

Median and 6-month survival stratified by risk group.

<p>Median and 6-month survival stratified by risk group.</p

Univariate analysis of tumor characteristics on overall survival of patients with advanced cancer.

<p>Univariate analysis of tumor characteristics on overall survival of patients with advanced cancer.</p

Univariate analysis of patient characteristics on survival in patients with advanced cancer.

<p>Univariate analysis of patient characteristics on survival in patients with advanced cancer.</p