ONLINE Special Article: Nursing care for patients with non-small cell lung cancer receiving adjuvant chemotherapy: Evidence–based implications for practice

Lorraine Martelli-Reid, Sue Baker, Christopher A. Smith, Christina Lacchetti, Yee C. Ung, William K. Evans


Oncology nurses provide care to patients and their families across the cancer care continuum including counselling patients on issues related to treatment completion, providing education directed towards the prevention of side effects, assessing and managing symptoms, and follow-up. Believing that a nursing-specific perspective related to these concerns was necessary to improve care for patients with resected, non-small cell lung cancer (NSCLC) receiving adjuvant chemotherapy, a nursing guidance report was initiated. This report was developed by utilizing evidence retrieved in a practice guideline report, general principles established by CANO/ACIO, Fitch’s supportive care model, and the clinical experiences of Lung DSG members. Evidence on the toxicity and adverse events that are caused by adjuvant chemotherapy and side effects and symptoms that are amenable to nursing intervention are highlighted and discussed.

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Alam, N., Darling, G., Shepherd, F.A., Mackay, J.A., Evans, W.K., &

Lung Cancer Disease Site Group of Cancer Care Ontario’s

Program in Evidence-Based Care. (2006). Postoperative

chemotherapy in nonsmall cell lung cancer: A systematic review.

The Annals of Thoracic Surgery, 81(5), 1926–1936.

Alam, N., Shepherd, F.A., Winton, T., Graham, B., Johnson, D.,

Livingston, R., et al. (2005). Compliance with post-operative

adjuvant chemotherapy in non-small cell lung cancer. An analysis

of National Cancer Institute of Canada and intergroup trial JBR.10

and a review of the literature. Lung Cancer, 47(3), 385-394.

Bredin, M., Corner, J., Krishnasamy, M., Plant, H., Bailey, C., &

A’Hern, R. (1999). Multicentre randomized controlled trial of

nursing intervention for breathlessness in patients with lung

cancer. British Medical Journal, 318, 901–904.

Canadian Association of Nurses in Oncology. (2002). CANO/ACIO

Practice Standards. Vancouver, BC: Author.

Carlson, L.E., & Bultz, B.D. (2004). Efficacy and medical cost offset

of psychosocial interventions in cancer care: Making the case for

economic analyses. Psychooncology, 13, 837–849.

Cooley, M.E. (2000) Symptoms in adults with lung cancer. A

systematic research review. Journal of Pain and Symptom

Management, 19(2), 137–153.

Douillard, J.Y., Rosell, R., De Lena, M., Carpagnano, F., Ramlau, R.,

Gonzales-Larriba, J.L., et al. (2006). Adjuvant vinorelbine plus

cisplatin versus observation in patients with completely resected

stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine

International Trialist Association [ANITA]): A randomised

controlled trial. The Lancet Oncology, 7(9), 719–727.

Douillard, J.Y., Rosell, R., De Lena, M., et al. (2005). ANITA: Phase

III adjuvant vinorelbine (N) and cisplantin (P) versus observation

(OBS) in completely resected (stage I-III) non-small cell lung

cancer (NSCLC) patients (pts): Final results after 70 months

median follow-up. Proceedings of the American Society for

Clinical Oncology, 23, 624S. A7013.

Fitch, M. (2003). Supportive care: Rebalancing efforts. In T. Sullivan,

W. Evans, H. Angus, & A. Hudson (Eds.), Strengthening the

quality of cancer services in Ontario (pp. 141–163). Ottawa,

ON: CHA Press.

Fitch, M. (1994). Providing supportive care for individuals living

with cancer. Toronto, ON: Ontario Cancer Treatment and

Research Foundation.

Ginsburg, M.L., Quirt, C., Ginsburg, A.D., & MacKillop, W.J. (1995).

Psychiatric illness and psychosocial concerns of patients with

newly diagnosed lung cancer. Canadian Medical Association

Journal, 152(5), 701–708.

Karnofsky, D., Abelmann, W., Craver, L., & Burchenal, J. (1948). The

use of nitrogen mustard in the palliative treatment of cancer.

Cancer, 1, 634–656.

Kurtz, M.E., Kurtz, J.C., Given, C.W., & Given, B. (2006). Predictors

of use of health care services among elderly lung cancer patients:

The first year after diagnosis. Support Care Cancer, 14, 243–250.

The London and South East Lung Cancer Forum for Nurses. (2004).

Guidelines on the role of the specialist nurse in supporting patients

with lung cancer. European Journal of Cancer Care, 13, 344–348.

Moore, S., Corner, J., Haviland, J., Wells, M., Salmon, E., Normand,

C., et al. (2002). Nurse-led follow-up and conventional medical

follow-up in management of patients with lung cancer:

Randomized trial. British Medical Journal, 325, 1145.

National Cancer Alliance. (1996). Patient-centred services? What

patients say. Oxford: NCA.

Newell, S.A., Sanson-Fisher, R.W., & Savolainen N.J. (2002).

Systematic review of psychological therapies for cancer patients:

Overview and recommendations for future research. Journal of

the National Cancer Institute, 94(8), 558–584.

Oken, M.M., Creech, R.H., Tormey, D.C., Horton, J., Davis, T.E.,

McFadden, E.T., et al. (1982). Toxicity and response criteria of the

Eastern Cooperative Oncology Group. American Journal of

Clinical Oncology, 5, 649–655.

Quinn, S. (1999). Lung cancer: The role of the nurse in treatment and

prevention. Nursing Standard, 13(41), 49–54.

Registered Nurses Association of Ontario. (2007). Integrating

smoking cessation counselling into daily nursing practice.

Revised. Toronto, ON: Author.

Shepherd, F., Winton, T., Livingston, R., et al. (2004). The impact of

adjuvant vinorelbine (VIN) and cisplatin (CIS) on quality of life

(QoL): Results from the National Cancer Institute of Canada

Clinical Trials Group Trial BR.10 randomized trial of VIN/CIS

versus observation in stage IB and II non-small cell. Annals of

Oncology, 15(Suppl. 3), A6270.

Winton, T., Livingston, R., Johnson, D., Rigas, J., Johnston, M.,

Butts, C., et al. (2005). Vinorelbine plus cisplatin vs. observation

in resected non-small-cell lung cancer. New England Journal of

Medicine, 352(25), 2589–2597.

Yosuke, U., Ichiro, M., Kanji, N., Yutaka, N., Tatsuo, A., & Hitoshi,

O. (2003). Depression and psychological distress in patients

during the year after curative resection of non–small-cell lung

cancer. Journal of Clinical Oncology, 21(1), 69–77.

Zabora, J., Brintzenhofeszoc, K., Curbow, B., & Piantadosi, S.

(2001). The prevalence of psychological distress by cancer site.

Psychooncology, 10, 19–28.


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