Evidence map›Paper›PMID 22430269›Full record

Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2012

Depression and survival in metastatic non-small-cell lung cancer: effects of early palliative care.

William F Pirl, Joseph A Greer, Lara Traeger, Vicki Jackson, Inga T Lennes, Emily R Gallagher, Pedro Perez-Cruz, Rebecca S Heist, Jennifer S Temel

Registry-linked trialAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01038271 (A Randomized, Controlled Trial of Integrated vs. Standard Palliative Care in Patients With Advanced NSCLC), which is not on this map. Cited by 89 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
89citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01038271 nacompletednot on this map

A Randomized, Controlled Trial of Integrated vs. Standard Palliative Care in Patients With Advanced NSCLC

TypeinterventionalSponsorMassachusetts General HospitalRan2006 to 2017Enrolled151ConditionsNon-small Cell Lung CancerArmsStandard Palliative Care Group, Integrated Palliative Care Intervention
3 · Its place in the literature

Who cites it

89 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2019
    Guideline
  4. Pooled it
  5. Pooled it
  6. Early palliative care for adults with advanced cancer.The Cochrane database of systematic reviews · 2017
    Pooled it
  7. Pooled it
  8. Pooled it
  9. Systemic Therapy for Stage IV Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2015
    Guideline
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2015
    Trial
  16. Randomized controlled trial of expressive writing for patients with renal cell carcinoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2014
    Trial
  17. Trial
  18. Article
  19. Article
  20. Article

29 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

William F PirlMassachusetts General Hospital Cancer Center, Center for Psychiatric Oncology and Behavioral Sciences, Yawkey 9A, 55 Fruit St, Boston, MA 02114, USA. wpirl@partners.org
Joseph A Greer
Lara Traeger
Vicki Jackson
Inga T Lennes
Emily R Gallagher
Pedro Perez-Cruz
Rebecca S Heist
Jennifer S Temel

Funding

Symptom Management Trial in Cancer SurvivorsK23CA115908 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI PIRL, WILLIAM F · 2006 to 2010
$706k
NCI NIH HHS K23 CA115908
6 · The paper itself

Abstract

purposeIn a randomized trial, early palliative care (EPC) in patients with metastatic non-small-cell lung cancer (NSCLC) was observed to improve survival. In a secondary analysis, we explored the hypothesis that the survival benefit resulted from improving depression. PATIENTS AND

methodsIn total, 151 patients with newly diagnosed metastatic NSCLC participated in a randomized trial of EPC integrated with standard oncology care versus standard oncology care alone. Depression was assessed at baseline and at 12 weeks with the Patient Health Questionnaire-9 (PHQ-9) and was scored diagnostically by using Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria for major depression syndrome (MDS). Depression response was considered ≥ 50% reduction in PHQ-9 scores at 12 weeks. Survival differences were tested with log-rank and Cox proportional hazards models.

resultsAt baseline, 21 patients (14%) met MDS criteria. MDS significantly predicted worse survival (hazard ratio, 1.82; P = .02). Patients assigned to EPC had greater improvements in PHQ-9 scores at 12 weeks (P < .001); among patients with MDS, those receiving EPC had greater rates of depression response at 12 weeks (P = .04). However, improvement in PHQ-9 scores was not associated with improved survival, except in a sensitivity analysis in which patients who died before 12 weeks were modeled to have worse depression. The group randomly assigned to EPC remained independently associated with survival after adding improvement in PHQ-9 scores to the survival model.

conclusionDepression predicted worse survival in patients with newly diagnosed metastatic NSCLC. Although EPC was associated with greater improvement in depression at 12 weeks, the data do not support the hypothesis that treatment of depression mediated the observed survival benefit from EPC.

Indexed as

AgedAge FactorsCarcinoma, Non-Small-Cell LungComorbidityDepressive DisorderFemaleHumansLung NeoplasmsMaleMiddle AgedPalliative CarePrognosisProportional Hazards ModelsQuality of LifeReference ValuesRisk Assessment

Identifiers

PMID22430269
PMCPMC3341144

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.