Early palliative care in advanced cancer: a systematic review
DOI:
https://doi.org/10.70577/asce.v4i4.404Keywords:
Cancer, Clinical Medicine, Medical Treatment, Quality of Life, Mental Health; WellbeingAbstract
Background: Advanced cancer has a negative impact on the patient’s wellbeing and functionality. Early palliative care (EPC) in conjunction with standard oncologic care may improve symptoms, quality of life, and even survival. Aim: To evaluate the effect of EPC on quality of life, symptom burden, and survival in adult patients with advanced cancer. Methods: Systematic Review. An advanced search for randomized controlled trials (RCTs) was executed in PubMed and Scopus. Eligible studies included adults with any advanced cancer and EPC integrated with standard oncologic care. Outcomes addressed were quality of life, anxiety, depression, symptom burden, and survival. Risk of bias was determined using the RoB-2 tool. Results: Sixteen RCTs were included (N= 3934, intervention= 1970, control= 1964). Twelve trials presented a low risk of bias. All RCTs reported better QoL scores in the EPC group than the control group, although only six reached statistical significance. Seven studies assessed psychological distress; two showed significant improvement in depression, and one in anxiety. Three trials analyzed survival; two reported significantly longer median survival time with EPC. No trial demonstrated consistent benefits for symptom severity. Conclusions: In adults with advanced cancer, EPC presented heterogeneous benefits in QoL and psychological distress. These findings suggest that cancer type and timing of integration affect overall outcomes, underscoring the need for tailored EPC programs adapted to each clinical context.
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