Outpatient Palliative Care Needs of Metastatic Cancer Patients Treated With Radiation Therapy

73 Background: It is unclear how frequently patients with metastatic cancer treated with radiation therapy have unmet physical, psychological, spiritual, and practical needs of patients. This study aims to determine the level of support needed to meet this burden. Methods: We performed a telephone survey to evaluate the unmet needs of living patients with stage IV metastatic cancer treated with radiation therapy at a single institution in the priot six months. Data were collected using the Palliative care Outcome Scale, a validated 12-question survey about unmet patient needs, and its associated symptom scale. We examined patient treatment history by reviewing medical records. Among 87 eligible patients treated, 45 had died, 19 could not be reached, and two declined participation. Thus, 21 patients were included in the analysis. Results: Most frequent diagnoses were lung (24%; 5/21) or colorectal cancer (19%; 4/21). Most patients’ recent radiation course had palliative intent (62%; 13/21), but eight had received ablative radiation. No patients were undergoing radiation treatment when the survey was administered, and 57% (12/21) were receiving chemotherapy. Despite most patients seeing a physician within 2 weeks of the survey (median 1.7 weeks; range 0-11.4 weeks), most patients reported pain (67%) and anxiety (57%), and about 50% reported these issues as moderate or worse. At least one-third of patients reported having each need unmet. Patients complained of a median of five symptoms, with 57% of patients reporting any symptom severe. Patients on chemotherapy (n = 12) reported more symptoms and increased symptom severity, but 44% of patients reported moderate pain even among those not undergoing any therapy. Conclusions: Patients with metastatic cancer recently treated with radiation therapy continue to have substantial needs that are often not being met by standard oncologic care, despite recent visits with physicians. Although many of these patients are receiving chemotherapy and may be identified for palliative care programs through the medical oncology service, radiation oncology clinics should also routinely integrate quality palliative care for patients with metastatic cancer.