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Objectives/Purpose: This two phase study of QOL and symptoms in lung cancer included Phase Ⅰ to determine usual care at a NCI designated comprehensive cancer center.Phase Ⅱ gained input from patients regarding QOL concems and pilot tested a palliative care intervention.Lung cancer impacts all dimensions of physical, psychological, social, and spiritual well being.Methods: In Phase Ⅰ, 100 patients were randomly selected by the tumor registry from 125 new lung cancer patients seen over a 12 month period.An audit tool reflecting aspects of quality care as described by the NCCN was developed, peer reviewed and tested to establish reliability.Care was audited for a 6 month period.In Phase Ⅱ 10 patients completed 4 quantitative tools and participated in a tape-recorded interview.Data was summarized into a care plan and shared with the interdisciplinary team at a case conference whereupon the care plan incorporated the team* suggestions.Follow-up with the patient occurred one and three months post conference to evaluate the impact of the intervention.Results: Phase Ⅰ data revealed 85% were stage Ⅲ-Ⅳ, 82% had comorbidities, 81% received chemotherapy and 43% had radiation therapy.Thirty two percent received no supportive care services.Uncontrolled symptoms were reasons for outpatient visits and for 38% of hospital readmissions.Phase Ⅱ data revealed 60% had stage Ⅲ-Ⅳ with COPD/emphysema and cardiac disease as common comorbidities.Symptom specific scores were moderate (X=20.6) as were overall scores for QOL using the FACT-L (X=87.8).Emotional well-being scores were the lowest (X=18.4) followed by functional (X-21.1), social/family (X=23.8), and physical (X=24.5).Supportive care services recommended included nutrition, psychology/psychiatry, social work, rehabilitation, and chaplaincy.Conclusions: QOL/symptom concerns are often neglected in usual care in lung cancer.An interdisciplinary palliative care intervention can prospectively meet these needs.