• Gaëlle Vanbutsele, Simon Van Belle, Veerle Surmont, Martine De Laat, Roos Colman, Kim Eecloo, Eline Naert, Marc De Man, Karen Geboes, Luc Deliens, and Koen Pardon.
• End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Belgium; Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Hematology, Ghent University Hospital, Ghent, Belgium. Electronic address: gaelle.vanbutsele@uzgent.be.
• Eur. J. Cancer. 2020 Jan 1; 124: 186-193.

PurposeThis study evaluated the effect of early integrated palliative care (PC) in oncology on quality of life (QOL) near the end of life and use of health care resources near the end of life.MethodPatients with advanced cancer and a life expectancy of approximately 1 year were randomly assigned to either early and systematic integration of PC into oncological care (intervention) or standard oncological care alone (control). QOL was assessed with the EORTC QLQ-C30 global health status/QOL scale and McGill Quality of Life (MQOL) Single Item Scale and Summary Scale at baseline, 12 weeks and 6 weekly thereafter until death. Use of health care resources was collected from chart review in patient's electronic medical file for patients who died while participating in the study.ResultsOf the 186 randomised patients, 185 participants had a baseline measurement and were analysed. By November 2017, 128 patients had died while participating in the study. When applying the terminal decline model, patients in the intervention group scored significantly higher on global health status/QOL of the EORTC QLQ C30, at 6 months (difference: 5.9 [0.06; 11.1], p = 0.03), 3 (difference: 6.8 [1.0; 12.6], p = 0.02), and 1 month (difference: 7.6 [0.7; 14.5], p = 0.03) prior to the patient's death compared to the control group. Similar results were found for the Single Item Scale and Summary Score of the MQOL. We did not observe differences in use of health care resources between groups.DiscussionEarly integrated palliative care in oncology is a valuable approach since it also increases QOL near the end of life and not only soon after initiation of PC.Copyright © 2019 Elsevier Ltd. All rights reserved.

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