Quality of life is significantly improved for patients with pancreatic cancer when systematic palliative care is administered vs on-demand palliative care, a study published in the European Journal of Cancer has shown.1
Early palliative care (EPC) is proven to have a positive impact on clinical outcomes for oncology patients; therefore, researchers sought to determine optimal timing for EPC activation in a prospective, multicenter randomized study.
For the study, 207 outpatients with metastatic or locally advanced inoperable pancreatic cancer were randomized to receive standard care plus on-demand EPC (n = 100) or standard care plus systematic EPC (n = 107). Change in quality of life between baseline (T0) and after 12 weeks (T1) was the primary outcome, assessed with the Functional Assessment of Cancer Therapy – Hepatobiliary questionnaire, specifically the integration of physical, functional, and Hepatic Cancer Subscale (HCS) combined in the Trial Outcome Index (TOI).
Mean changes in TOI scores were –4.47 for T0 and –0.63 for T1, with a difference of 3.83 between the groups (95% CI, 0.10-7.57; P =.041). Mean changes in HCS scores were –2.23 for T0 and 0.28 for T1, with a difference of 2.51 between the groups (95% CI, 0.40-4.61; P =.022). Scores favored the interventional group. Quality of life scores at 12 weeks were 84.4 vs 78.1 (P =.022) on the TOI scale, and 52.0 vs 48.2 (P = .008) on the HCS, for interventional and standard arm, respectively. Of the 186 evaluable patients, 143 (76.9%) had died as February 2016; no difference in overall survival was seen between the treatment arms.
1. Maltoni M, Scarpi E, Dall’Agata M, et al; Early Palliative Care Italian Study Group (EPCISG). Systematic versus on-demand early palliative care: results from a multicentre, randomized clinical trial. Eur J Cancer. 2016 Jul 27. doi: 10.1016/j.ejca.2016.06.007. [Epub ahead of print]