On this page
Quick Reference
Overview and Recommendations
Background
- •Early palliative care (EPC) integrated with standard oncology care at diagnosis of advanced NSCLC improves quality of life (mean FACT-L 98.0 vs 91.5), reduces depressive symptoms (16% vs 38% at 12 weeks), and is associated with a median survival benefit of 2.7 months (11.6 vs 8.9 months), the foundation of the Temel trial (2010) that changed practice.
- •The American Society of Clinical Oncology (ASCO) provisional clinical opinion recommends that patients with metastatic non-small-cell lung cancer be offered concurrent palliative care and standard oncologic care at initial diagnosis, and the NCCN guidelines similarly emphasize a multidisciplinary team approach.
- •EPC optimizes end-of-life care: patients receiving EPC have half the odds of receiving chemotherapy within 60 days of death (OR 0.47), a longer interval from last intravenous chemotherapy to death (median 64 vs 40.5 days), and higher enrollment in hospice for >1 week (60% vs 33.3%).
- •Alternative delivery models have been validated: video visits (REACH trial) are equivalent to in-person for QOL, while a stepped-care model (visits triggered by QOL decline) is noninferior for QOL but results in fewer hospice days (19.5 vs 34.6), suggesting that less intensive palliative care may compromise end-of-life continuity.
- •The survival benefit of EPC has been replicated globally: the PACO trial in Mexico (median OS 18.1 vs 10.5 months) and the E-warm interdisciplinary model in China (24.6 vs 20.4 months; HR 0.19) confirm that early integration improves outcomes across diverse healthcare settings.
Evaluation
- •Suspect the need for palliative care integration in every patient with newly diagnosed advanced NSCLC, regardless of symptom burden, the evidence supports initiating EPC within 8 weeks of diagnosis, not waiting for symptom escalation.
- •Ask about the four cardinal symptoms that drive palliative intervention: dyspnea (exertional and at rest), cough with or without hemoptysis, pain (site, severity, character), and fatigue. Quantify pain on a 0-10 numeric rating scale.
- •Assess hemoptysis risk in detail before any antiangiogenic therapy: inquire about episodes of bright red blood ≥2.5 mL within the past 3 months and document tumor histology (squamous vs non-squamous). Both are absolute contraindications to bevacizumab.
- •Examine performance status using the ECOG scale (0-5), better status predicts response to palliative thoracic radiotherapy (OR per point 0.71), and document weight loss, which may guide nutritional support and prognosis.
- •Order baseline quality-of-life assessment with the FACT-L (Functional Assessment of Cancer Therapy-Lung) and depression screening with the PHQ-9 or equivalent. The Temel trial used these tools to track outcomes.
- •For patients with brain metastases not eligible for stereotactic radiosurgery (SRS) or surgical resection, evaluate for whole-brain radiotherapy (WBRT) vs optimal supportive care alone using the QUARTZ trial criteria: no survival or QOL benefit from WBRT in this group, so dexamethasone alone is a reasonable default.
- •Assess prognostic awareness through repeated conversations about incurability, a single disclosure is insufficient. Patients who have had both recent and past discussions are 5 times more likely to have accurate awareness at 3 months (AOR 5.08), which reduces preference for life-prolonging treatment (AOR 0.39).
- •Evaluate caregiver burden systematically using the Zarit Burden Interview; a score ≥29 indicates mild-moderate burden. Identify caregivers providing >6 hours of daily care, as this is associated with significantly lower health-related quality of life.
- •Order chest CT for any patient with hemoptysis to identify the bleeding site and assess for tumor cavitation (OR 9.6 for severe pulmonary hemorrhage with bevacizumab). Bronchoscopy may be needed for central airway obstruction.
- •In the end-of-life phase, assess for terminal symptoms: dyspnea, pain, death rattle, and delirium. Use validated tools like the Edmonton Symptom Assessment System (ESAS) to track symptom burden daily.
Management
- •Initiate early palliative care referral within 8 weeks of diagnosis of advanced NSCLC, with scheduled visits at least monthly, this is the protocol that produced the survival and QOL benefits in the Temel trial.
- •For hemoptysis, first exclude contraindications to bevacizumab: do not administer bevacizumab in patients with predominantly squamous histology or a history of clinically significant hemoptysis (≥2.5 mL within 3 months). If cavitation is present, consider an alternative antiangiogenic agent.
- •In severe pulmonary hemorrhage, immediately stabilize the airway (endotracheal intubation), correct hypoxia, support blood pressure, and transfuse as needed. Then perform bronchoscopic therapy (rigid bronchoscopy preferred for massive bleeding) or bronchial artery embolization (BAE), first-line for persistent hemorrhage, achieving 89% immediate symptom palliation.
- •Administer external beam radiotherapy (short course, 2-5 fractions) for hemoptysis palliation; it resolves hemoptysis in ≥70% of patients with unresectable lung cancer.
- •Permanently discontinue bevacizumab in any patient who develops grade 3 or 4 bleeding.
- •For pain management, follow the WHO ladder: opioids are first-line for moderate-to-severe pain. For dyspnea, use morphine 2.5-5 mg orally or intravenously every 4 hours as needed; add benzodiazepines if anxiety is present.
- •Avoid the combination of erlotinib (150 mg daily) with COX-2 inhibitors (e.g., celecoxib 400 mg BID) in patients with a history of peptic ulcer disease or those requiring therapeutic anticoagulation, this combination caused grade 3/4 upper GI bleeding in 15% of patients in a phase II trial.
- •For brain metastases unsuitable for SRS or surgery, manage with dexamethasone alone and omit whole-brain radiotherapy (WBRT). The QUARTZ trial showed no difference in survival (HR 1.06), quality of life, or dexamethasone use; mean QALY difference was only 4.7 days, meeting non-inferiority criteria.
- •For palliative thoracic radiotherapy, use doses >30 Gy (e.g., 39 Gy in 13 fractions or 42 Gy in 15 fractions with concurrent chemotherapy) for better survival. For tumors >7 cm, concurrent chemoradiotherapy (42 Gy/15 fractions) improves median survival from 9.7 to 13.4 months (p=0.001).
- •For endobronchial brachytherapy (HDR-EBIRT), expect 87.7% complete or major symptom response within 3 months for central airway obstruction. Median survival is 13 months in responders vs 7 months in non-responders. Fatal hemoptysis occurs in 7.8%.
- •For bone metastases, use single-fraction radiotherapy (8 Gy) for pain palliation, it is as effective as multi-fraction regimens and preferred in the palliative setting to minimize patient visits.
- •For adrenal metastases, use stereotactic body radiotherapy (SBRT) with BED10 ≥50 Gy (≤12 fractions) for superior 1-year freedom from local progression compared with palliative RT.
- •For sleeve lobectomy with microscopic residual disease (R1), avoid converting to pneumonectomy; adjuvant radiotherapy improves overall survival and reduces distant recurrence.
- •In end-of-life care, manage terminal secretions (death rattle) with anticholinergics: glycopyrrolate 0.2-0.4 mg IV/SC every 4-6 hours as needed, or scopolamine 1.5 mg transdermal patch every 72 hours.
- •Treat delirium with haloperidol 0.5-2 mg orally or IV every 6-8 hours as needed; search for reversible causes such as opioid neurotoxicity, hypercalcemia, or infection.
- •Withdraw non-beneficial treatments (chemotherapy, IV fluids, artificial nutrition) when burdens outweigh benefits. Ensure equity in end-of-life care, patients with dementia receive less opioid use and fewer palliative care consultations; actively address these disparities.
- •Use disease-centred advance directives that detail NSCLC-specific complications (e.g., hemoptysis, dyspnea) to improve physician concordance with patient wishes (concordance 0.83 vs 0.60 for generic directives).
- •Engage caregivers in repeated discussions about incurability and prognosis; provide psychosocial support through mind-body interventions (e.g., brief couple-based interventions, yoga programs) which have shown large effect sizes for reducing sleep disturbances (d=1.83) and depressive symptoms in partners (d=0.90).
- •Refer to hospice when prognosis is ≤6 months; early palliative care increases the likelihood of hospice enrollment >1 week (NNT=4) and reduces aggressive end-of-life care (NNT=5). The stepped-care model, while scalable, may compromise hospice days (19.5 vs 34.6).
- •Monitor for esophagitis in patients receiving hypofractionated palliative RT (30-54 Gy, 2.5-4 Gy/fraction): 31% develop esophagitis (26% grade 2-3). Concurrent chemotherapy increases risk; oral steroids reduce it. Esophageal Dmax ≥40 Gy is the strongest predictor, and Dmean ≤20 Gy is protective.
Board Review — High Yield
- •Early Palliative Care, Initiated within 8 weeks of diagnosis of advanced NSCLC; improves QOL, reduces depression, and prolongs survival (Temel trial: 11.6 vs 8.9 months).
- •Bevacizumab contraindication, Squamous histology or hemoptysis ≥2.5 mL within 3 months; cavitation increases risk of severe pulmonary hemorrhage (OR 9.6).
- •QUARTZ trial, Omit whole-brain radiotherapy in NSCLC brain metastases unsuitable for SRS/surgery; no survival or QOL benefit over dexamethasone alone.
- •Bronchial artery embolization, First-line for persistent pulmonary hemorrhage; 89% immediate symptom palliation.
- •Prognostic awareness, Repeated discussions about incurability improve accurate awareness (AOR 5.08) and reduce preference for life-prolonging treatment (AOR 0.39).
- •Caregiver burden, 62.6% report mild-moderate burden; >6 hours daily care lowers HRQoL; mind-body interventions show large effect sizes.
- •Single-fraction RT, 8 Gy for bone metastases pain palliation; as effective as multi-fraction and preferred in palliative setting.
- •HDR-EBIRT, Endobronchial brachytherapy yields 87.7% symptom response for central airway obstruction; fatal hemoptysis risk 7.8%.
- •Stepped-care model, Noninferior for QOL but associated with fewer hospice days (19.5 vs 34.6), suggesting less intensive palliative care may compromise end-of-life continuity.
- •Disease-centred advance directives, Improve physician concordance with patient wishes (0.83 vs 0.60 for generic directives).
Deep Dive — Evidence Details
When to Integrate Palliative Care
- ▸Early palliative care improves QOL, reduces depression, and prolongs survival by 2.7 months [6].
- ▸Refer within 8 weeks of diagnosis; monthly visits are standard.
Palliative care should be integrated early, beginning at diagnosis of advanced NSCLC. The landmark trial of 151 patients with metastatic NSCLC demonstrated that early palliative care (EPC) improved quality of life (mean FACT-L 98.0 vs 91.5; P=0.03), reduced depressive symptoms (16% vs 38%; P=0.01), and was associated with longer median survival (11.6 vs 8.9 months; P=0.02) [6]A1b. EPC also optimized end-of-life care: patients had half the odds of receiving chemotherapy within 60 days of death (OR 0.47; P=0.05), longer interval between last IV chemo and death (median 64 vs 40.5 days; P=0.02), and higher hospice enrollment >1 week (60% vs 33.3%) [4]A1b[5]A1b. EPC is initiated within 8 weeks of diagnosis, with scheduled visits at least monthly [6]A1b. Alternative delivery models include video visits (REACH trial: equivalent QOL) [12]A1b and stepped-care (noninferior QOL but fewer hospice days) [13]A1b. The PACO trial confirmed survival benefit in resource-limited settings [14]A1b. ASCO guidelines recommend concurrent palliative care and standard oncologic care at initial diagnosis for metastatic NSCLC [11]B2b.
| Question | Position A | Position B | Strength | Implication |
|---|---|---|---|---|
| Optimal delivery model: stepped vs early palliative care | Stepped care is noninferior for QOL and more scalable [13]A1b | Early care (monthly visits) remains standard for ensuring adequate hospice days [6]A1b | Step-care may reduce workforce burden but could compromise end-of-life care intensity [13]A1b | Clinicians should consider patient preferences and local resources when choosing between models |
Pearl: Initiate a palliative care referral within 8 weeks of diagnosis for all patients with advanced NSCLC, regardless of symptom burden, as early integration improves quality of life, mood, and survival, and optimizes end-of-life care.
| Trial (Year) | N | Intervention | Key Results |
|---|---|---|---|
| Temel et al. (2010) [6]A1b | 151 | EPC integrated with standard oncology care vs standard care alone | Improved QOL (mean FACT-L 98.0 vs 91.5; P=0.03), fewer depressive symptoms (16% vs 38%; P=0.01), longer median survival (11.6 vs 8.9 months; P=0.02) |
| PACO (2024) [14]A1b | 146 | EPC + standard care vs standard care alone in Mexico | Median OS 18.1 vs 10.5 months (P=0.029); greatest benefit in patients with baseline QOL >70 |
| Chen et al. (2023) [17]A1b | 280 | Combined early palliative care (E-warm model) vs standard care | Longer OS (24.6 vs 20.4 months; HR 0.19; 95% CI 0.04-0.85; P=0.029), improved QOL, pain, nutrition |
| REACH (2024) [12]A1b | 1250 | Video vs in-person EPC | Equivalent QOL at 24 weeks (mean 99.7 vs 97.7; difference 2.0; 90% CI 0.1-3.9; P=0.04 for equivalence) |
Symptom Management
- ▸Bevacizumab contraindicated with squamous histology or hemoptysis ≥2.5 mL [24].
- ▸Pain: pemetrexed maintenance delays pain worsening (HR 0.76) [22].
Hemoptysis occurs in 30-60% of NSCLC patients. Bevacizumab is contraindicated with squamous histology or hemoptysis ≥2.5 mL within 3 months [24]D5. Baseline tumor cavitation increases risk of severe pulmonary hemorrhage (PH) (OR 9.6; P=0.034) [23]B2b. Central tumor location does not preclude bevacizumab [23]B2b[24]D5. Pain: maintenance pemetrexed (500 mg/m² q21d) delays pain worsening (HR 0.76; 95% CI 0.59-0.99; P=0.041) [22]A1b. COX-2 inhibitors with erlotinib increase risk of upper GI bleeding (15% grade 3/4); avoid in patients with peptic ulcer disease or anticoagulation [25]B2b. Management of severe PH: airway maintenance, CT scan, bronchoscopic therapy, bronchial artery embolization (89% immediate palliation), radiotherapy (short course, 2-5 fractions resolves ≥70%), and permanent bevacizumab discontinuation for grade ≥3 bleeding [24]D5. Avoid combining stereotactic ablative radiotherapy (SABR) with VEGF inhibitors for ultracentral tumors due to high PH risk (3-year incidence 45% vs 9.0%) [32]B2b.
| Risk Factor | Recommendation | Strength of Evidence |
|---|---|---|
| Predominantly squamous histology | Do not administer bevacizumab | Excluded from phase III trials [24]D5 |
| History of hemoptysis ≥2.5 mL within 3 months | Do not administer bevacizumab | Excluded from phase III trials [24]D5 |
| Baseline tumor cavitation | Consider alternative antiangiogenic; increased PH risk (OR 9.6) | Retrospective case-control, small numbers [23]B2b |
| Central tumor location (non-squamous) | Does not preclude bevacizumab | Multiple studies show no significant association [23]B2b[24]D5 |
Pearl: For patients with advanced NSCLC who develop hemoptysis, first exclude squamous histology and cavitation as risk factors for severe PH, then consider bronchial artery embolization or hypofractionated radiotherapy for palliation, while permanently discontinuing bevacizumab if grade ≥3 bleeding occurs.
Psychosocial, Spiritual, and Caregiver Support
- ▸Only 54% of patients have accurate prognostic awareness; repeated discussions improve awareness (AOR 5.08) [41].
- ▸Interdisciplinary palliative care improves QOL, spiritual well-being, and advance care directive completion [49].
Only 54% of patients and 51% of caregivers have accurate prognostic awareness at baseline [41]B2b. Repeated discussions about incurability (both recent and past) improve accurate awareness at 3 months (AOR 5.08; 95% CI 1.31-19.78) and reduce preference for life-prolonging treatment (AOR 0.39) [41]B2b. Psychosocial interventions: brief couple-based mind-body intervention reduced sleep disturbances (d=1.83) and cancer-specific distress (d=0.61) in patients, and depressive symptoms in partners (d=0.90) [51]C4. Vivekananda Yoga improved mental health (d=0.84) and decreased caregiver sleep disturbances (d=1.44) [50]B2b. Wellness education improved emotional well-being and family cohesion [43]A1b[47]A1b. Interdisciplinary palliative care improved QOL (109.1 vs 101.4), spiritual well-being (38.1 vs 36.2), and distress (2.2 vs 3.3), and increased advance care directive completion (44% vs 9%) [49]B2b. Caregiver burden: 62.6% report mild to moderate burden; predictors include duration of caregiving, passive coping, and anxiety [56]B3b. Providing >6 hours of daily care is associated with lower caregiver HRQoL [57]B3b. Aligned communication about treatment goals is needed, as 36% of caregivers expect cure from palliative chemotherapy [45]B3b.
Pearl: Repeated discussions about incurability (not just a single disclosure) are associated with a 5-fold increase in accurate prognostic awareness, which in turn reduces preference for life-prolonging treatment [41]B2b.
| Study | Population | Main Burden Measure | Key Finding |
|---|---|---|---|
| Zhu et al. 2022 [56]B3b | Early-stage NSCLC, postsurgical | Zarit Burden Interview (ZBI) | Mean ZBI 29.1; 62.6% mild-moderate burden; predictors: duration, passive coping, anxiety |
| Yang et al. 2024 [57]B3b | Advanced NSCLC (stage IIIB-IV) | EQ-5D-5L | Mean utility 0.92; 45.39% anxiety/depression; spouses and >6 hr/day caregiving associated with lower HRQoL |
| Wood et al. 2018 [60]B3b | Advanced NSCLC, France/Germany/Italy | ZBI, WPAI | Mean 29.5 hr/week caregiving; work impairment 21-30%; worse health status in later-line caregivers |
| Ma et al. 2023 [58]B3b | NSCLC receiving combined chemotherapy | Benefit Finding Scale (BFS) | Symptom burden inversely correlated with benefit finding (r = -0.609 to -0.151) |
| Viñolas et al. 2020 [46]B3b | Metastatic NSCLC, Spain | Zarit, economic impact | No sex differences in economic burden; more parents as caregivers for female patients |
Palliative Procedures
- ▸Palliative thoracic RT response rate 70% [69].
- ▸QUARTZ trial: WBRT no benefit over supportive care for brain metastases unsuitable for surgery/SRS [63].
Palliative thoracic radiotherapy (PTR) relieves cough, hemoptysis, dyspnea, and pain with overall response rate 70% [69]B3b. Response more likely with better ECOG performance status (OR 0.71 per point) and EGFR-mutant tumors (OR 2.46) [69]B3b. Poor-prognosis patients with stage III NSCLC and tumors >7 cm benefit from concurrent chemoradiotherapy (42 Gy/15 fractions) vs chemotherapy alone (median survival 13.4 vs 9.7 months; P=0.001) [65]A1b. Esophagitis is main toxicity; Dmax ≥40 Gy strongest predictor, Dmean ≤20 Gy protective [73]B3b. Brain metastases: QUARTZ trial showed no survival or QOL benefit from whole-brain radiotherapy (WBRT) compared to supportive care (dexamethasone) in patients unsuitable for surgery or SRS; mean QALY difference 4.7 days [63]A1b. For limited brain metastases, SRS preferred. Endobronchial brachytherapy: 87.7% symptom response within 3 months; median survival 13 months in responders; fatal hemoptysis 7.8% [79]B3b. Palliative sleeve lobectomy with R1 status is acceptable over pneumonectomy in poor surgical candidates; adjuvant radiotherapy improves survival [70]B3b. Adrenal metastases: SBRT (BED10 ≥50 Gy) yields superior local control [72]C4. Bone metastases: single-fraction RT (8 Gy) as effective as multi-fraction for pain palliation [61]B2a.
Pearl: For NSCLC patients with brain metastases unsuitable for surgery or SRS, omit whole-brain radiotherapy and manage with dexamethasone alone; the QUARTZ trial showed no survival or quality-of-life benefit from WBRT, saving patients from unnecessary treatment burden.
| Regimen | Total Dose | Fractions | Setting | Evidence |
|---|---|---|---|---|
| Short-course | 10 Gy | 1 | Poor prognosis, PS ≥2, urgent palliation | [61]B2a[64]A1b |
| Short-course | 16 Gy | 2 (separated by 1 week) | Alternative short-course | [64]A1b |
| Hypofractionated | 30 Gy | 10 | Moderate prognosis | [61]B2a[73]B3b |
| Hypofractionated | 42 Gy | 15 | Concurrent chemoradiation, poor prognosis stage III | [65]A1b[66]A1b |
| Moderate hypofractionation | 39 Gy | 13 | Protracted palliative monotherapy | [64]A1b |
End-of-Life Care and Hospice
- ▸Early palliative care increases hospice enrollment >1 week (60% vs 33%, NNT=4) [4].
- ▸Terminal dyspnea: morphine 2.5-5 mg every 4 hours PRN.
Hospice eligibility requires prognosis ≤6 months; median survival after first admission with metastatic disease is 3.8 months [90]C4. Early palliative care dramatically improves hospice outcomes: patients more likely to enroll for >1 week (60% vs 33.3%; NNT=4) and had longer interval from last IV chemo to death (median 64 vs 40.5 days) [4]A1b. Aggressive care remains common: 70% have at least one aggressive care criterion in last month [86]B3b, 20% receive chemotherapy within 14 days of death [83]A1b, 42% die in acute hospital [94]B3b. Early palliative care reduces aggressive treatment (33% vs 54%; NNT=5) [4]A1b. Advance care planning (ACP) should begin early; disease-centred advance directives improve physician concordance with patient wishes (0.83 vs 0.60) [82]C4. Both recent and past discussions about incurability improve accurate prognostic awareness (AOR 5.08) and reduce preference for life-prolonging treatment (AOR 0.39) [41]B2b. Terminal symptom management: dyspnea - morphine 2.5-5 mg q4h PRN; pain - opioids; terminal secretions - glycopyrrolate or scopolamine; delirium - haloperidol 0.5-2 mg. Non-beneficial treatments (chemotherapy, IV fluids, artificial nutrition) should be withdrawn when burdens outweigh benefits. Ensure equity: patients with dementia receive less opioid use (61.8% vs 70.8%) and fewer palliative care consultations [88]B3b.
Pearl: The single most impactful intervention for improving end-of-life care in NSCLC is early, integrated palliative care; it reduces aggressive treatment, improves hospice utilization, and prolongs survival, achieving a 2.7-month median survival gain [6]A1b with an NNT of 5 to avoid aggressive end-of-life care.
| Indicator | Target / Benchmark | Evidence |
|---|---|---|
| Hospice enrollment >1 week | ≥60% | [4]A1b |
| Chemotherapy within 14 days of death | <20% (observed: 20%) | [83]A1b |
| Chemotherapy within 30 days of death | <33.9% (observed) | [89]B3b |
| ICU admission in last month | <10% (observed: 5%) | [94]B3b |
| In-hospital death | <42% (observed); target <20% | [94]B3b |
| Palliative care consultation | ≥50% (observed: 50%) | [86]B3b |
| Invasive procedures in last month | <15% (observed: 15%) | [91]B3b |
| Aggressive care (≥1 criterion) | <33% (observed: 70%) | [86]B3b |
| Advance directive completion | ≥44% (observed: 44% with intervention) | [49]B2b |
Related Pages
- ▸Use child pages for detailed management of specific modalities.
- ▸Parent page provides diagnosis and staging context.
Part of the Non-Small Cell Lung Cancer family. Cross-cutting management is split across dedicated child pages:
- : diagnostic page (definition, epidemiology, staging, biomarkers, prognosis)
- Non-Small Cell Lung Cancer Surgical Management : operations by stage, fertility-sparing options, sentinel node mapping, adjuvant triggers (Sedlis / Peters)
- Non-Small Cell Lung Cancer Radiation Management : EBRT + image-guided brachytherapy + concurrent chemoradiation, dose / fractionation, OAR constraints
- Non-Small Cell Lung Cancer Systemic Therapy : concurrent / adjuvant / metastatic chemotherapy, targeted therapy, immune checkpoint inhibitors
- : post-treatment surveillance schedule, late toxicity, survivorship, patient counselling
- Non-Small Cell Lung Cancer Recurrent and Metastatic Disease : local-regional salvage, distant metastatic systemic therapy, oligometastatic disease
Pearl: Use these links to hop between management modalities; the parent Non-Small Cell Lung Cancer page carries diagnosis + staging that informs every decision here.
References
- [1]
Reid E, Suneja G, Ambinder RF et al.. “Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology.” Journal of the National Comprehensive Cancer Network : JNCCN (2018). PMID: 30099375 ↗
L1GUIDELINECited in: When to Integrate Palliative Care - [2]
Jazieh AR, Bamefleh H, Demirkazik A et al.. “Modification and implementation of NCCN guidelines on non-small cell lung cancer in the Middle East and North Africa region.” Journal of the National Comprehensive Cancer Network : JNCCN (2010). PMID: 20697125 ↗
L1GUIDELINECited in: When to Integrate Palliative Care - [3]
Pirl WF, Greer JA, Traeger L et al.. “Depression and survival in metastatic non-small-cell lung cancer: effects of early palliative care.” Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2012). PMID: 22430269 ↗
L1RCTCited in: When to Integrate Palliative Care - [4]
Greer JA, Pirl WF, Jackson VA et al.. “Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer.” Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2011). PMID: 22203758 ↗
L1RCTCited in: When to Integrate Palliative Care, End-of-Life Care and Hospice - [5]
Temel JS, Greer JA, Admane S et al.. “Longitudinal perceptions of prognosis and goals of therapy in patients with metastatic non-small-cell lung cancer: results of a randomized study of early palliative care.” Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2011). PMID: 21555700 ↗
L1RCTCited in: When to Integrate Palliative Care - [6]
Temel JS, Greer JA, Muzikansky A et al.. “Early palliative care for patients with metastatic non-small-cell lung cancer.” The New England journal of medicine (2010). PMID: 20818875 ↗
L1RCTCited in: When to Integrate Palliative Care, End-of-Life Care and Hospice - [7]
. “Chemotherapy in addition to supportive care improves survival in advanced non-small-cell lung cancer: a systematic review and meta-analysis of individual patient data from 16 randomized controlled trials.” Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2008). PMID: 18678835 ↗
L1SR_MA_RCTCited in: When to Integrate Palliative Care - [8]
Siena S, Crinò L, Danova M et al.. “Dose-dense temozolomide regimen for the treatment of brain metastases from melanoma, breast cancer, or lung cancer not amenable to surgery or radiosurgery: a multicenter phase II study.” Annals of oncology : official journal of the European Society for Medical Oncology (2009). PMID: 19767314 ↗
L2NON_RANDOMIZED_TRIALCited in: When to Integrate Palliative Care, Palliative Procedures - [9]
Camerini A, Valsuani C, Mazzoni F et al.. “Phase II trial of single-agent oral vinorelbine in elderly (> or =70 years) patients with advanced non-small-cell lung cancer and poor performance status.” Annals of oncology : official journal of the European Society for Medical Oncology (2009). PMID: 19914959 ↗
L2NON_RANDOMIZED_TRIALCited in: When to Integrate Palliative Care - [10]
Temel JS, Jackson VA, Billings JA et al.. “Phase II study: integrated palliative care in newly diagnosed advanced non-small-cell lung cancer patients.” Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2007). PMID: 17557950 ↗
L2NON_RANDOMIZED_TRIALCited in: When to Integrate Palliative Care - [11]
Smith TJ, Temin S, Alesi ER et al.. “American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care.” Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2012). PMID: 22312101 ↗
L2NON_RANDOMIZED_TRIALCited in: When to Integrate Palliative Care - [12]
Greer JA, Temel JS, El-Jawahri A et al.. “Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer: A Multisite Randomized Clinical Trial.” JAMA (2024). PMID: 39259563 ↗
L1RCTCited in: When to Integrate Palliative Care - [13]
Temel JS, Jackson VA, El-Jawahri A et al.. “Stepped Palliative Care for Patients With Advanced Lung Cancer: A Randomized Clinical Trial.” JAMA (2024). PMID: 38824442 ↗
L1RCTCited in: When to Integrate Palliative Care, End-of-Life Care and Hospice - [14]
Allende S, Turcott JG, Verástegui E et al.. “Early Incorporation to Palliative Care (EPC) in Patients With Advanced Non-Small Cell Lung Cancer: The PACO Randomized Clinical Trial.” The oncologist (2024). PMID: 38558247 ↗
L1RCTCited in: When to Integrate Palliative Care - [15]
Lehman M, Bernard A, See A et al.. “A Randomized Phase 3 Trial of Palliative Radiation Therapy Versus Concurrent Chemotherapy and Palliative Radiation Therapy in Patients With Good Performance Status, Locally Advanced, or Metastatic Non-Small Cell Lung Cancer With Symptoms due to Intrathoracic Disease Who are Not Suitable for Radical Chemo-radiation Therapy: Results of the Trans-Tasman Radiation Oncology Group 11.03 Trial.” Practical radiation oncology (2020). PMID: 33271352 ↗
L1RCTCited in: When to Integrate Palliative Care - [16]
Ettinger DS, Wood DE, Akerley W et al.. “Non-small cell lung cancer, version 1.2015.” Journal of the National Comprehensive Cancer Network : JNCCN (2014). PMID: 25505215 ↗
L5OTHERCited in: When to Integrate Palliative Care - [17]
Chen M, Yu H, Yang L et al.. “Combined early palliative care for non-small-cell lung cancer patients: a randomized controlled trial in Chongqing, China.” Frontiers in oncology (2023). PMID: 37781179 ↗
L1RCTCited in: When to Integrate Palliative Care - [18]
Kuo JC, Graham DM, Salvarrey A et al.. “A randomized trial of the electronic Lung Cancer Symptom Scale for quality-of-life assessment in patients with advanced non-small-cell lung cancer.” Current oncology (Toronto, Ont.) (2020). PMID: 32489264 ↗
L1RCTCited in: When to Integrate Palliative Care - [19]
Lee KJ, Kwon JH, Kim DH et al.. “Efficacy of Herbal Medicine Therapy Combined With Palliative Chemotherapy in Unresectable Advanced NSCLC: A Systematic Review and Meta-Analysis.” Integrative cancer therapies (2025). PMID: 41103125 ↗
L1SR_MA_RCTCited in: When to Integrate Palliative Care - [20]
Gridelli C, Maione P, Rossi A et al.. “Chemotherapy of advanced NSCLC in special patient population.” Annals of oncology : official journal of the European Society for Medical Oncology (2006). PMID: 16807469 ↗
L5NARRATIVE_REVIEWCited in: When to Integrate Palliative Care - [21]
van Doormaal FF, Di Nisio M, Otten HM et al.. “Randomized trial of the effect of the low molecular weight heparin nadroparin on survival in patients with cancer.” Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2011). PMID: 21502549 ↗
L1RCTCited in: Symptom Management - [22]
Belani CP, Brodowicz T, Ciuleanu TE et al.. “Quality of life in patients with advanced non-small-cell lung cancer given maintenance treatment with pemetrexed versus placebo (H3E-MC-JMEN): results from a randomised, double-blind, phase 3 study.” The Lancet. Oncology (2012). PMID: 22336221 ↗
L1RCTCited in: Symptom Management - [23]
Sandler AB, Schiller JH, Gray R et al.. “Retrospective evaluation of the clinical and radiographic risk factors associated with severe pulmonary hemorrhage in first-line advanced, unresectable non-small-cell lung cancer treated with Carboplatin and Paclitaxel plus bevacizumab.” Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2009). PMID: 19224857 ↗
L2NON_RANDOMIZED_TRIALCited in: Symptom Management - [24]
Reck M, Barlesi F, Crinò L et al.. “Predicting and managing the risk of pulmonary haemorrhage in patients with NSCLC treated with bevacizumab: a consensus report from a panel of experts.” Annals of oncology : official journal of the European Society for Medical Oncology (2011). PMID: 22056855 ↗
L5NARRATIVE_REVIEWCited in: Symptom Management - [25]
Fidler MJ, Argiris A, Patel JD et al.. “The potential predictive value of cyclooxygenase-2 expression and increased risk of gastrointestinal hemorrhage in advanced non-small cell lung cancer patients treated with erlotinib and celecoxib.” Clinical cancer research : an official journal of the American Association for Cancer Research (2008). PMID: 18381949 ↗
L2NON_RANDOMIZED_TRIALCited in: Symptom Management - [26]
Molins L, Lanuti M, Force S et al.. “Evaluation of a Powered Vascular Stapler in Video-Assisted Thoracic Surgery Lobectomy.” The Journal of surgical research (2020). PMID: 32320894 ↗
L1RCTCited in: Symptom Management - [27]
Meybohm P, Choorapoikayil S, Zinn S et al.. “Removal of EpCAM-positive tumor cells during intraoperative blood salvage- A pivotal multicenter clinical study (REMOVE).” Journal of clinical anesthesia (2025). PMID: 40812168 ↗
L2NON_RANDOMIZED_TRIALCited in: Symptom Management - [28]
Horne ZD, Richman AH, Dohopolski MJ et al.. “Stereotactic body radiation therapy for isolated hilar and mediastinal non-small cell lung cancers.” Lung cancer (Amsterdam, Netherlands) (2017). PMID: 29290248 ↗
L2NON_RANDOMIZED_TRIALCited in: Symptom Management - [29]
Ma J, Li X, Zhao S et al.. “Robot-assisted thoracic surgery versus video-assisted thoracic surgery for lung lobectomy or segmentectomy in patients with non-small cell lung cancer: a meta-analysis.” BMC cancer (2021). PMID: 33941112 ↗
L1SR_MA_RCTCited in: Symptom Management - [30]
Hireche K, Canaud L, Lounes Y et al.. “Thoracoscopic Versus Open Lobectomy After Induction Therapy for Nonsmall Cell Lung Cancer: New Study Results and Meta-analysis.” The Journal of surgical research (2022). PMID: 35465975 ↗
L2SR_COHORTCited in: Symptom Management - [31]
Zeng W, Zhang W, Zhang J et al.. “Systematic review and meta-analysis of video-assisted thoracoscopic surgery segmentectomy versus lobectomy for stage I non-small cell lung cancer.” World journal of surgical oncology (2020). PMID: 32106856 ↗
L2SR_COHORTCited in: Symptom Management - [32]
Lau BC, Wu YF, No HJ et al.. “Pulmonary Hemorrhage in Patients Treated With Thoracic Stereotactic Ablative Radiotherapy and Antiangiogenic Agents.” Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer (2023). PMID: 37085030 ↗
L2PROSPECTIVE_COHORTCited in: Symptom Management - [33]
Urbanic JJ, Wang X, Bogart JA et al.. “Phase 1 Study of Accelerated Hypofractionated Radiation Therapy With Concurrent Chemotherapy for Stage III Non-Small Cell Lung Cancer: CALGB 31102 (Alliance).” International journal of radiation oncology, biology, physics (2018). PMID: 29487024 ↗
L4PHASE_1_TRIALCited in: Symptom Management - [34]
Greystoke A, Steele N, Arkenau HT et al.. “SELECT-3: a phase I study of selumetinib in combination with platinum-doublet chemotherapy for advanced NSCLC in the first-line setting.” British journal of cancer (2017). PMID: 28950288 ↗
L4PHASE_1_TRIALCited in: Symptom Management - [35]
Wang Z, Pang L, Tang J et al.. “Video-assisted thoracoscopic surgery versus muscle-sparing thoracotomy for non-small cell lung cancer: a systematic review and meta-analysis.” BMC surgery (2019). PMID: 31615490 ↗
L2SR_COHORTCited in: Symptom Management - [36]
Huang L, Huang X, Zhou Y et al.. “Robotic-assisted versus video-assisted thoracoscopic anatomical pulmonary resection in elderly patients with lung cancer: A propensity score-matched comparison of short-term outcomes.” European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (2026). PMID: 42061191 ↗
L3COHORTCited in: Symptom Management - [37]
Li HJ, Ding JY, Nie Q et al.. “Advantages of robotic-assisted thoracic surgery after neoadjuvant therapy in NSCLC: A propensity score-matched analysis.” European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (2025). PMID: 40250266 ↗
L3COHORTCited in: Symptom Management - [38]
Gulikers JL, Otten LS, Hendriks LEL et al.. “Proactive monitoring of drug-drug interactions between direct oral anticoagulants and small-molecule inhibitors in patients with non-small cell lung cancer.” British journal of cancer (2024). PMID: 38862741 ↗
L4COHORTCited in: Symptom Management - [39]
Huang YW, Zhang Y, Li ZP et al.. “Association between a four-parameter inflammatory index and all-cause mortality in critical ill patients with non-traumatic subarachnoid hemorrhage: a retrospective analysis of the MIMIC-IV database (2012-2019).” Frontiers in immunology (2023). PMID: 37936706 ↗
L3COHORTCited in: Symptom Management - [40]
Farha N, Faisal MS, Allende DS et al.. “Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center.” The oncologist (2023). PMID: 36905577 ↗
L4COHORTCited in: Symptom Management - [41]
Hasegawa T, Okuyama T, Uemura T et al.. “Prognostic Awareness and Discussions of Incurability in Patients with Pretreated Non-Small Cell Lung Cancer and Caregivers: A Prospective Cohort Study.” The oncologist (2022). PMID: 36067268 ↗
L2PROSPECTIVE_COHORTCited in: Psychosocial, Spiritual, and Caregiver Support, End-of-Life Care and Hospice - [42]
Milbury K, Li Y, Durrani S et al.. “A Mindfulness-Based Intervention as a Supportive Care Strategy for Patients with Metastatic Non-Small Cell Lung Cancer and Their Spouses: Results of a Three-Arm Pilot Randomized Controlled Trial.” The oncologist (2020). PMID: 32621630 ↗
L4RCTCited in: Psychosocial, Spiritual, and Caregiver Support - [43]
Li Y, Ling L, Zhanyu P. “Effect of Wellness Education on Quality of Life of Patients With Non-Small Cell Lung Cancer Treated With First-Line Icotinib and on Their Family Caregivers.” Integrative cancer therapies (2019). PMID: 31043093 ↗
L1RCTCited in: Psychosocial, Spiritual, and Caregiver Support - [44]
Gustafson DH, DuBenske LL, Namkoong K et al.. “An eHealth system supporting palliative care for patients with non-small cell lung cancer: a randomized trial.” Cancer (2013). PMID: 23355273 ↗
L1RCTCited in: Psychosocial, Spiritual, and Caregiver Support - [45]
Ikander T, Jeppesen SS, Hansen O et al.. “Patients and family caregivers report high treatment expectations during palliative chemotherapy: a longitudinal prospective study.” BMC palliative care (2021). PMID: 33637063 ↗
L3COHORTCited in: Psychosocial, Spiritual, and Caregiver Support - [46]
Viñolas NN, Garcia-Campelo R, Majem M et al.. “Assessment of the psychosocial and economic impact according to sex in non-small cell lung cancer patients: an exploratory longitudinal study.” BMC psychology (2020). PMID: 33228796 ↗
L3COHORTCited in: Psychosocial, Spiritual, and Caregiver Support - [47]
Yanwei L, Minghui F, Manman Q et al.. “Influence of wellness education on first-line icotinib hydrochloride patients with stage IV non-small cell lung cancer and their family caregivers.” Current problems in cancer (2018). PMID: 29731164 ↗
L1RCTCited in: Psychosocial, Spiritual, and Caregiver Support - [48]
Nguyen HQ, Ruel N, Macias M et al.. “Translation and Evaluation of a Lung Cancer, Palliative Care Intervention for Community Practice.” Journal of pain and symptom management (2018). PMID: 30076966 ↗
L2NON_RANDOMIZED_TRIALCited in: Psychosocial, Spiritual, and Caregiver Support - [49]
Ferrell B, Sun V, Hurria A et al.. “Interdisciplinary Palliative Care for Patients With Lung Cancer.” Journal of pain and symptom management (2015). PMID: 26296261 ↗
L2NON_RANDOMIZED_TRIALCited in: Psychosocial, Spiritual, and Caregiver Support, End-of-Life Care and Hospice - [50]
Milbury K, Mallaiah S, Lopez G et al.. “Vivekananda Yoga Program for Patients With Advanced Lung Cancer and Their Family Caregivers.” Integrative cancer therapies (2015). PMID: 25917816 ↗
L2NON_RANDOMIZED_TRIALCited in: Psychosocial, Spiritual, and Caregiver Support - [51]
Milbury K, Engle R, Tsao A et al.. “Pilot Testing of a Brief Couple-Based Mind-Body Intervention for Patients With Metastatic Non-Small Cell Lung Cancer and Their Partners.” Journal of pain and symptom management (2017). PMID: 29208478 ↗
L4NON_RANDOMIZED_TRIALCited in: Psychosocial, Spiritual, and Caregiver Support - [52]
Bhattacharya P, Dessain SK, Evans TL. “Palliative Care in Lung Cancer: When to Start.” Current oncology reports (2018). PMID: 30414010 ↗
L5NARRATIVE_REVIEWCited in: Psychosocial, Spiritual, and Caregiver Support - [53]
Chandrasekar D, Tribett E, Ramchandran K. “Integrated Palliative Care and Oncologic Care in Non-Small-Cell Lung Cancer.” Current treatment options in oncology (2016). PMID: 27032645 ↗
L5NARRATIVE_REVIEWCited in: Psychosocial, Spiritual, and Caregiver Support - [54]
Kaptein AA, Kobayashi K, Matsuda A et al.. “We're in this together: Patients', caregivers' and health care providers' illness perceptions about non-small-cell lung cancer (NSCLC).” Lung cancer (Amsterdam, Netherlands) (2015). PMID: 26520188 ↗
L5NARRATIVE_REVIEWCited in: Psychosocial, Spiritual, and Caregiver Support - [55]
Lissoni P, Messina G, Parolini D et al.. “A spiritual approach in the treatment of cancer: relation between faith score and response to chemotherapy in advanced non-small cell lung cancer patients.” In vivo (Athens, Greece) (2008). PMID: 18853749 ↗
L2NON_RANDOMIZED_TRIALCited in: Psychosocial, Spiritual, and Caregiver Support - [56]
Zhu S, Yang C, Mei W et al.. “Caregiver burden for informal caregivers of patients after surgical treatment of early-stage lung cancer.” Journal of clinical nursing (2022). PMID: 35869414 ↗
L3CROSS_SECTIONALCited in: Psychosocial, Spiritual, and Caregiver Support - [57]
Yang Y, Liu L, Chen J et al.. “Does caring for patients with advanced non-small cell lung cancer affect health-related quality of life of caregivers? A multicenter, cross-sectional study.” BMC public health (2024). PMID: 38238722 ↗
L3CROSS_SECTIONALCited in: Psychosocial, Spiritual, and Caregiver Support - [58]
Ma L, Zhu K, Shi C et al.. “Association between the patients' symptom burden and their family caregivers' benefit finding in non-small cell lung cancer receiving combined chemotherapy.” Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (2023). PMID: 36729306 ↗
L3CROSS_SECTIONALCited in: Psychosocial, Spiritual, and Caregiver Support - [59]
Orr LD, Vanderpoel J, Vadagam P et al.. “Patient, care partner, and provider voice in treatment decision-making for non-small cell lung cancer.” Patient education and counseling (2025). PMID: 40215576 ↗
L3CROSS_SECTIONALCited in: Psychosocial, Spiritual, and Caregiver Support - [60]
Wood R, Taylor-Stokes G, Lees M. “The humanistic burden associated with caring for patients with advanced non-small cell lung cancer (NSCLC) in three European countries-a real-world survey of caregivers.” Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (2018). PMID: 30121787 ↗
L3CROSS_SECTIONALCited in: Psychosocial, Spiritual, and Caregiver Support - [61]
Liao Z, Rivin Del Campo E, Salem A et al.. “Optimizing lung cancer radiation treatment worldwide in COVID-19 outbreak.” Lung cancer (Amsterdam, Netherlands) (2020). PMID: 32585497 ↗
L2SR_COHORTCited in: Palliative Procedures - [62]
Duggan KJ, Wiltshire J, Strutt R et al.. “Palliative care and psychosocial care in metastatic non-small cell lung cancer: factors affecting utilisation of services and impact on patient survival.” Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (2018). PMID: 30066201 ↗
L1RCTCited in: Palliative Procedures - [63]
Mulvenna P, Nankivell M, Barton R et al.. “Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non-inferiority, randomised trial.” Lancet (London, England) (2016). PMID: 27604504 ↗
L1RCTCited in: Palliative Procedures - [64]
Jeremic B, Fidarova E, Sharma V et al.. “The International Atomic Energy Agency (IAEA) randomized trial of palliative treatment of incurable locally advanced non small cell lung cancer (NSCLC) using radiotherapy (RT) and chemotherapy (CHT) in limited resource setting.” Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (2015). PMID: 26163093 ↗
L1RCTCited in: Palliative Procedures - [65]
Strøm HH, Bremnes RM, Sundstrøm SH et al.. “Poor prognosis patients with inoperable locally advanced NSCLC and large tumors benefit from palliative chemoradiotherapy: a subset analysis from a randomized clinical phase III trial.” Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer (2014). PMID: 24807158 ↗
L1RCTCited in: Palliative Procedures - [66]
Strøm HH, Bremnes RM, Sundstrøm SH et al.. “Concurrent palliative chemoradiation leads to survival and quality of life benefits in poor prognosis stage III non-small-cell lung cancer: a randomised trial by the Norwegian Lung Cancer Study Group.” British journal of cancer (2013). PMID: 23963145 ↗
L1RCTCited in: Palliative Procedures - [67]
Zhou D, Zhao N, Xu H et al.. “The safety and efficacy of immunotherapy and palliative radiotherapy in patients with metastatic non-small cell lung cancer: a systematic review and meta-analysis of 13 prospective studies.” Expert review of anticancer therapy (2023). PMID: 37272502 ↗
L1SR_MA_RCTCited in: Palliative Procedures - [68]
Paappanen V, Järvenpää H, Jukkola A et al.. “Impact of Treatment Decisions on Survival Outcomes in Elderly Patients With Non-Small Cell Lung Cancer: A Retrospective Real-World Study.” Clinical oncology (Royal College of Radiologists (Great Britain)) (2025). PMID: 41027332 ↗
L3RETROSPECTIVE_COHORTCited in: Palliative Procedures - [69]
Xu Y, Trach C, Tessier T et al.. “Outcomes of patients receiving urgent palliative radiotherapy for advanced lung cancer: an observational study.” BMC palliative care (2024). PMID: 39709422 ↗
L3COHORTCited in: Palliative Procedures - [70]
Ren J, Huang J, Wang Z et al.. “Acceptability of palliative sleeve lobectomy with microscopic margin disease in patients with non-small cell lung cancer: A retrospective study.” Surgery (2024). PMID: 39455386 ↗
L3COHORTCited in: Palliative Procedures - [71]
Quiñones-Avila V, Ortiz-Ortiz KJ, Ríos-Motta R et al.. “Use of palliative radiotherapy among patients with metastatic non-small-cell lung cancer in Puerto Rico.” BMC palliative care (2021). PMID: 34389004 ↗
L3RETROSPECTIVE_COHORTCited in: Palliative Procedures - [72]
Buergy D, Würschmidt F, Gkika E et al.. “Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis.” International journal of cancer (2021). PMID: 33682927 ↗
L4RETROSPECTIVE_COHORTCited in: Palliative Procedures - [73]
Nieder C, Imingen KS, Mannsåker B et al.. “Risk factors for esophagitis after hypofractionated palliative (chemo) radiotherapy for non-small cell lung cancer.” Radiation oncology (London, England) (2020). PMID: 32357936 ↗
L3COHORTCited in: Palliative Procedures - [74]
Støchkel Frank M, Schou Nørøxe D, Nygård L et al.. “Fractionated palliative thoracic radiotherapy in non-small cell lung cancer - futile or worth-while?” BMC palliative care (2018). PMID: 29304789 ↗
L4COHORTCited in: Palliative Procedures - [75]
Kiss N, Isenring E, Gough K et al.. “The prevalence of weight loss during (chemo)radiotherapy treatment for lung cancer and associated patient- and treatment-related factors.” Clinical nutrition (Edinburgh, Scotland) (2013). PMID: 24325888 ↗
L3COHORTCited in: Palliative Procedures - [76]
Cañón V, López-Guerra JL, Arteagoitia A et al.. “Impact of Radiation Dose on the Survival of Patients With Non-small Cell Lung Cancer Treated With Palliative Intent: Results of a Multicenter Prospective Study.” Anticancer research (2024). PMID: 39626908 ↗
L3COHORTCited in: Palliative Procedures - [77]
Mehnert E, Möller FS, Hofbauer C et al.. “Palliative care of proximal femur metastatic disease and osteolytic lesions: results following surgical and radiation treatment.” BMC cancer (2024). PMID: 39574021 ↗
L3COHORTCited in: Palliative Procedures - [78]
Nieder C, Imingen KS. “Palliative Radiotherapy for Non-metastatic Non-small-cell Lung Cancer: Impact of Blood Test Results on Survival.” In vivo (Athens, Greece) (2023). PMID: 36881095 ↗
L3RETROSPECTIVE_COHORTCited in: Palliative Procedures - [79]
Soror T, Kovács G, Wecker S et al.. “Palliative treatment with high-dose-rate endobronchial interventional radiotherapy (Brachytherapy) for lung cancer patients.” Brachytherapy (2021). PMID: 34429246 ↗
L3COHORTCited in: Palliative Procedures - [80]
Mor V, Wagner TH, Levy C et al.. “Association of Expanded VA Hospice Care With Aggressive Care and Cost for Veterans With Advanced Lung Cancer.” JAMA oncology (2019). PMID: 30920603 ↗
L3COHORTCited in: End-of-Life Care and Hospice - [81]
Parikh RB, Ferrell WJ, Girard A et al.. “The Impact of Machine Learning Mortality Risk Prediction on Clinician Prognostic Accuracy and Decision Support: A Randomized Vignette Study.” Medical decision making : an international journal of the Society for Medical Decision Making (2025). PMID: 40613383 ↗
L1RCTCited in: End-of-Life Care and Hospice - [82]
Koenig JFL, Asendorf T, Simon A et al.. “"SpezPat"- common advance directives versus disease-centred advance directives: a randomised controlled pilot study on the impact on physicians' understanding of non-small cell lung cancer patients' end-of-life decisions.” BMC palliative care (2022). PMID: 36167565 ↗
L4RCTCited in: End-of-Life Care and Hospice - [83]
Fujisawa D, Temel JS, Traeger L et al.. “Psychological factors at early stage of treatment as predictors of receiving chemotherapy at the end of life.” Psycho-oncology (2015). PMID: 25959002 ↗
L1RCTCited in: End-of-Life Care and Hospice - [84]
Beijer S, van Rossum E, Hupperets PS et al.. “Application of adenosine 5'-triphosphate (ATP) infusions in palliative home care: design of a randomized clinical trial.” BMC public health (2007). PMID: 17210069 ↗
L1RCTCited in: End-of-Life Care and Hospice - [85]
Oswalt CJ, Nakatani MM, Troy J et al.. “Timing of Palliative Care Consultation Impacts End of Life Care Outcomes in Metastatic Non-Small Cell Lung Cancer.” Journal of pain and symptom management (2024). PMID: 39002711 ↗
L3COHORTCited in: End-of-Life Care and Hospice - [86]
Martin A, Carton M, Thery L et al.. “Palliative care integration and end-of-life care intensity for patients with NSCLC.” Lung cancer (Amsterdam, Netherlands) (2024). PMID: 38728972 ↗
L3COHORTCited in: End-of-Life Care and Hospice - [87]
Hasegawa T, Okuyama T, Uemura T et al.. “Elements of End-of-Life Discussions Associated With Patients' Reported Outcomes and Actual End-of-Life Care in Patients With Pretreated Lung Cancer.” The oncologist (2024). PMID: 37669003 ↗
L3COHORTCited in: End-of-Life Care and Hospice - [88]
Hirooka K, Okumura Y, Matsumoto S et al.. “Quality of End-of-Life in Cancer Patients With Dementia: Using A Nationwide Inpatient Database.” Journal of pain and symptom management (2022). PMID: 35367609 ↗
L3COHORTCited in: End-of-Life Care and Hospice - [89]
Casebeer A, Antol DD, DeClue RW et al.. “The Relationship Between Guideline-Recommended Initiation of Therapy, Outcomes, and Cost for Patients with Metastatic Non-Small Cell Lung Cancer.” Journal of managed care & specialty pharmacy (2018). PMID: 29799325 ↗
L3COHORTCited in: End-of-Life Care and Hospice - [90]
Collins A, Sundararajan V, Burchell J et al.. “Transition Points for the Routine Integration of Palliative Care in Patients With Advanced Cancer.” Journal of pain and symptom management (2018). PMID: 29608934 ↗
L4COHORTCited in: End-of-Life Care and Hospice - [91]
Tukey MH, Faricy-Anderson K, Corneau E et al.. “Procedural Aggressiveness in Veterans with Advanced Non-Small-Cell Lung Cancer at the End of Life.” Journal of palliative medicine (2017). PMID: 29265906 ↗
L3RETROSPECTIVE_COHORTCited in: End-of-Life Care and Hospice - [92]
Yoo SH, Keam B, Kim M et al.. “The Effect of Hospice Consultation on Aggressive Treatment of Lung Cancer.” Cancer research and treatment (2017). PMID: 28707460 ↗
L3COHORTCited in: End-of-Life Care and Hospice - [93]
Ersek M, Miller SC, Wagner TH et al.. “Association between aggressive care and bereaved families' evaluation of end-of-life care for veterans with non-small cell lung cancer who died in Veterans Affairs facilities.” Cancer (2017). PMID: 28419414 ↗
L3COHORTCited in: End-of-Life Care and Hospice - [94]
Philip J, Hudson P, Bostanci A et al.. “Metastatic non-small cell lung cancer: a benchmark for quality end-of-life cancer care?” The Medical journal of Australia (2015). PMID: 25669476 ↗
L3RETROSPECTIVE_COHORTCited in: End-of-Life Care and Hospice
Backlinks
- ← Non-Small Cell Lung Cancer Surgical Management (Detailed)
- ← Non-Small Cell Lung Cancer Surgical Management
- ← Non-Small Cell Lung Cancer Recurrent and Metastatic Disease
- ← Non-Small Cell Lung Cancer Radiation Management
- ← Non-Small Cell Lung Cancer Systemic Therapy (Detailed)
- ← Non-Small Cell Lung Cancer Recurrent and Metastatic Disease (Detailed)
- ← Non-Small Cell Lung Cancer Radiation Management (Detailed)
- ← Non-Small Cell Lung Cancer Systemic Therapy