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).

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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]