Cuidados paliativos tempranos en cáncer avanzado: revisión sistemática
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https://doi.org/10.70577/asce.v4i4.404Palabras clave:
Cáncer, Medicina Clínica, Tratamiento Médico, Calidad de Vida, Salud Mental, BienestarResumen
Introducción: El cáncer avanzado tiene un impacto negativo en el bienestar y funcionalidad de los pacientes. Los cuidados paliativos tempranos (CPT) junto al cuidado oncológico estándar podría mejorar los síntomas, calidad de vida e incluso la supervivencia. Objetivo: Evaluar los efectos de los CPT en la calidad de vida, sintomatología y supervivencia en adultos con cáncer avanzado Métodos: Revisión sistemática. Se ejecutó una búsqueda avanzada de ensayos clínicos aleatorizados en PubMed y Scopus. Fueron incluidos estudios realizados en adultos con cáncer avanzado de cualquier tipo e integración temprana de cuidados paliativos al cuidado oncológico estándar. Los desenlaces analizados incluyeron: calidad de vida, ansiedad, depresión, severidad de sintomatología y supervivencia. El riesgo de sesgo se evaluó con la herramienta RoB- 2. Resultados: Fueron incluidos (N=3934 pacientes, Intervención: 1970, Control: 1964). Doce ensayos tuvieron bajo riesgo de sesgo. Todos los ensayos mostraron mejores puntajes en la calidad de vida frente al control, solo en seis la diferencia fue significativa. Siete estudios evaluaron depresión y ansiedad; dos tuvieron mejoría significativa sobre depresión y uno en ansiedad. Dos de tres ensayos que evaluaron supervivencia mostraron medianas significativamente mayores respecto al control. Ningún ensayo mostró beneficios significativos sobre la severidad de sintomatología. Conclusiones: En adultos con cáncer avanzado, los CPT muestran beneficios heterogéneos en la calidad de vida y sintomatología. Los resultados sugieren que el tipo de cáncer y el tiempo de integración influyen en los desenlaces, por lo que su aplicación debe ajustarse a cada contexto clínico.
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