Effects of Integrating Palliative Care in Patients With Advanced Cancer: A Systematic Review and Meta-Analysis of Quality of Life and Psychological Outcomes.

Abstract

Background: Patients with advanced cancer frequently have a wide range of mental and physical symptoms, making it difficult for them to communicate and make informed decisions. Necessitating the incorporation of palliative care in this population to meet their supportive care requirements. Objective: To investigate the effects of integrating Palliative care in advanced cancer patients. Methods: PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were comprehensively and systematically searched for Randomized clinical trials (RCTs) published up to February 2024. According to the PICOS criteria, trials enrolling adult patients with advanced cancer subjected to PC were included. Moreover, a risk of bias assessment was performed using the Cochrane Risk of Bias tool, and statistical analyses were performed using the Review Manager software. Results: Only 13 RCTs with 3,294 advanced cancer patients were included in the final analysis. A pooled analysis of data from these trials revealed that patients subjected to PC had improved quality of life (QoL) scores than those receiving standard care (SMD: 0.18; 95% CI: 0.07 - 0.30; p = 0.002). However, no significant difference was observed in depression (SMD: -0.03; 95% CI: -0.16 - 0.10; p = 0.63), anxiety (SMD: - 0.04; 95% CI: -0.23 - 0.15; p = 0.69), and survival (OR: 0.81; 95% CI: 0.56 - 1.16; p = 0.25). Conclusion: Integrating PC in patients with advanced cancer results in improved QoL with limited effect on psychological distress symptoms.