Systematic Review for the Follow-up of Curatively Treated Patients With Lung Cancer.

Introduction: The follow-up of patients with lung cancer after curative-intent treatment should include strategies to improve their quality of life and survival. These could include the monitoring and management of symptoms of recurrence and late toxicities from cancer treatments, the use of patient-reported outcome (PRO) tools, and smoking cessation interventions. The objective of this systematic review was to examine these follow-up strategies.

Materials and methods: This systematic review was developed by Ontario Health (Cancer Care Ontario)'s Program in Evidence-Based Care. MEDLINE, EMBASE, and the Cochrane Library were searched for systematic reviews and randomized controlled trials (RCTs) comparing different types of clinicians, PRO tools, smoking cessation interventions, and management strategies for signs, symptoms, risk factors, comorbidities, or late toxicities in adult patients with NSCLC or SCLC after curative-intent treatment.

Results: Thirty-five RCTs and nineteen systematic reviews were included. For nurse-led interventions, either significant effects were found in favor of the intervention, or no significant effects were found. The results for the use of PRO tools were mixed, possibly due to differences in comparators and settings. Evidence suggested that smoking cessation interventions might benefit these patients (RR, 0.84; 95% CI, 0.68-1.03). There was limited evidence in the target population for the management of signs, symptoms, risk factors, comorbidities, or late toxicities.

Conclusions: Smoking cessation interventions, exercise training, and the use of PRO tools may benefit these patients. The results of this systematic review were used to inform recommendations in a clinical practice guideline. Further RCTs in this patient population are needed.