School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan.
School of Nursing, Department of Nursing, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.
Am J Hosp Palliat Care. 2022 Nov;39(11):1350-1357. doi: 10.1177/10499091221075570. Epub 2022 Mar 1.
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. 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). 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 3 months (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 3 months (SMD = .18, 95% CI = .06-.31) and in TOI ≤ 3 months (SMD = .28, 95% CI = .11-.45). 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.
晚期癌症患者常伴有生活质量（QoL）下降和与癌症相关的症状。早期姑息治疗可能会改善他们的 QoL 和症状严重程度。我们对早期姑息治疗对晚期癌症患者的 QoL、症状严重程度和其他结局的影响进行了荟萃分析，并在 PubMed、Embase、CINAHL、MEDLINE 和 Cochrane Library 数据库中搜索了潜在的随机对照试验（RCT）。主要结局为 QoL。次要结局为症状强度和功能健康（试验结局指数，TOI）。研究方案已在 PROSPERO（CRD42020164047）上注册并获得批准。我们获得了 12 项 RCT，共纳入 2980 名参与者。与常规护理相比，早期姑息治疗在≤3 个月（SMD =.16，95%CI =.05-.27）和治疗超过 3 个月（SMD =.26，95%CI =.11-.40）时显著改善 QoL。与常规治疗相比，接受早期姑息治疗的患者在治疗超过 3 个月时症状强度显著降低（SMD =.18，95%CI =.06-.31），在 TOI 小于等于 3 个月时也显著降低（SMD =.28，95%CI =.11-.45）。早期姑息治疗可改善晚期癌症患者的 QoL、症状强度和 TOI。我们建议为晚期癌症患者引入早期姑息治疗，因为与常规护理相比，该方法提供了额外的临床益处。
