Early palliative care for improving quality of life and survival in patients with advanced cancer: a systematic review and meta-analysis

Zanghelini, F., Zimmermann, I. R., Souza de Andrade, C. A. and Wu, O. (2018) Early palliative care for improving quality of life and survival in patients with advanced cancer: a systematic review and meta-analysis. Journal of Palliative Care and Medicine, 8(5), 1000343. (doi: 10.4172/2165-7386.1000343)

Abstract

Objective: The main goal was to evaluate the effectiveness of early palliative care in patients with advanced cancer. Methods: The search in the MEDLINE/PubMed, CRD, Cochrane Library, CINAHL, EMBASE, Google Scholar, ICTRP and ClinicalTrials.gov databases was conducted in June 2017. Two reviewers independently screened titles and abstracts with consensus agreement. We undertook quality assessment according to GRADE criteria. Randomized Controlled Trials (RCT) that assessed the effectiveness of EPC in adult patients with a diagnosis- advanced cancer were included. The quantitative evidence was summarized in a meta-analysis using random effect models. Results: The selection phase retrieved 14,026 records, 7 papers were included in the meta-analysis. The standardized mean difference the outcomes assessed were: improvement quality of life (0.17 higher; 95% CI; 0.05, 0.29) after 3 months, (0.42 higher; 95% CI; 0.21, 0.63) after 6 months, and (0.16 higher; 95% CI; -0.20, 0.53) after 12 months; improvement of symptom intensity (-0.13 lower; 95% CI; -0.26, 0.00) after 3 months, (-0.27 lower; 95% CI; -0.53, -0.01) after 6 months, and (-0.39 lower; 95% CI; -0.76, -0.03) after 12 months; improve depressive mood (-0.19 lower; 95% CI; - 0.36, -0.01) after 3 months, (-0.21 lower; 95% CI; -0.45, 0.04) after 6 months, and (-0.09 lower; 95% CI; -0.81, 0.63) after 12 months; and survival (OR = 0.71 higher; 95% CI; 0.51, 0.99). Conclusion: Our findings suggest that EPC effectively improves quality of life and consequently increases the likelihood of survival of patients with advanced or metastatic cancer. However, due to worsening of the disease stage over time, a limited effect was observed after 12 months of follow-up.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Zanghelini, Fernando and Wu, Professor Olivia
• Authors: Zanghelini, F., Zimmermann, I. R., Souza de Andrade, C. A., and Wu, O.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
• Journal Name: Journal of Palliative Care and Medicine
• Publisher: OMICS Publishing Group
• ISSN: 2165-7386
• ISSN (Online): 2165-7386
• Published Online: 05 October 2018
• Copyright Holders: Copyright © 2018 Zanghelini F, et al.
• First Published: First published in Journal of Palliative Care and Medicine 8(5): 1000343
• Publisher Policy: Reproduced under a Creative Commons License