Effects of Early Palliative Care in Advanced Cancer Patients: A Meta-Analysis.

Abstract

Objective: Advanced cancer patients often suffer from a reduced quality of life (QoL) and cancer-related symptoms. Early palliative care may improve their QoL and symptom severity. Methods: We conducted a meta-analysis of the effects of early palliative care on QoL, symptom severity, and other outcomes in advanced cancer patients, and searched PubMed, Embase, CINAHL, MEDLINE, and the Cochrane Library databases for potential randomized controlled trials (RCTs). The primary outcome was QoL. The secondary outcomes were symptom intensity and functional well-being (Trial Outcome Index, TOI). The study protocol has been registered and approved by PROSPERO (CRD42020164047). Results: We obtained 12 RCTs enrolling 2980 participants. Compared with the usual care, early palliative care significantly improved QoL at ≤ 3 months (SMD = .16, 95% CI = .05-.27) and when treated more 3months (SMD = .26, 95% CI = .11-.40). Compared with usual treatment, patients who received early palliative care exhibited a significant reduction in symptom intensity when treated more than 3months (SMD = .18, 95% CI = .06-.31) and in TOI ≤ 3months (SMD = .28, 95% CI = .11-.45). Conclusions: Early palliative care improves QoL, symptom intensity, and TOI in advanced cancer patients. We recommend introducing early palliative care for advanced cancer patients as the approach provides additional clinical benefits compared with usual care.