早期专科姑息治疗 (PC) 参与转移性非小细胞肺癌 (mNSCLC) 与改善生活质量、减少积极的临终 (EoL) 护理和延长生存期相关。随着 NSCLC 治疗模式的发展，PC 利用率仍然较低。这项工作探讨了 PC 参与的时间和程度如何影响免疫治疗时代 mNSCLC 的结果和患者体验。这项回顾性综述分析了开始一线治疗的 mNSCLC 患者2015 年 3 月至 2019 年 7 月期间在杜克大学接受化疗、免疫疗法或联合化学免疫疗法治疗。PC 会诊和结果数据截至 2022 年 11 月。使用描述性统计分析 EoL 护理变量。根据期间是否接受 PC 会诊，对 152 名患者进行了分层。他们的病程。 80 名患者 (53%) 从未见过 PC，而 72 名见过 PC 的患者 (47%) 根据首次接触 PC 的时间和就诊总次数进一步分层。 31% 的患者在诊断后 2 个月内就诊（早期），33% 的患者在诊断后 2-6 个月内就诊（中期），36% 的患者在诊断后 6 个月后（晚期）就诊。与其他组相比，接受早期 PC 治疗的患者平均接受临终关怀时间较长（35 天），积极的 EoL 护理率较低（43%），院内死亡频率较低（14%）。这项真实世界研究研究表明，尽管早期 PC 整合已被证明具有益处，但在 mNSCLC 中，转诊至 PC 的情况仍然较晚或根本不转诊。早期门诊 PC 转诊可延长临终关怀时间、降低积极的临终关怀频率以及降低院内死亡率。版权所有 © 2024。由 Elsevier Inc. 出版。

Early specialist palliative care (PC) involvement in metastatic non-small cell lung cancer (mNSCLC) is associated with improved quality of life, less aggressive end of life (EoL) care, and longer survival. As treatment paradigms for NSCLC have evolved, PC utilization remains low.This work examines how the timing and extent of PC involvement impacts outcomes and the patient experience in mNSCLC in the era of immunotherapy.This retrospective review analyzed patients with mNSCLC who initiated first-line treatment with chemotherapy, immunotherapy, or combined chemoimmunotherapy at Duke University between March 2015 and July 2019. PC consultation and outcomes data were abstracted through November 2022. EoL care variables were analyzed using descriptive statistics.152 patients were stratified based on whether PC was consulted during their disease course. 80 patients (53%) never saw PC, while the 72 patients (47%) who saw PC were further stratified by time to first PC encounter and total number of PC visits. 31% were seen within 2 months of diagnosis (early), 33% between 2-6 months (intermediate), and 36% after 6 months (late). Patients who received early PC had longer median time on hospice (35 days), had lower rates of aggressive EoL care (43%), and experienced less frequent in-hospital death (14%) compared to other groups.This real-world study reveals that referrals to PC still occur late or not at all in mNSCLC despite demonstrated benefits of early PC integration. Early outpatient PC referrals resulted in longer time on hospice, lower frequency of aggressive EoL care, and lower rates of in-hospital death.Copyright © 2024. Published by Elsevier Inc.