Background: To assess the role of early palliative care in patients with advanced oncologic
and non-oncologic chronic diseases.
Methods: A qualitative systematic review of literature was performed. All the randomized phase III
trials comparing early, simultaneous palliative care and standard care in patients with advanced
oncologic and non-oncologic diseases were considered eligible and included into the analysis. The
outcomes were classified into 6 classes: quality of life, symptoms control, overall survival, quality of
care, patients’ and caregivers’ satisfaction, and costs of the assistance.
Results: Twelve papers reporting the data of 9 trials were considered eligible and included into the analysis. Two nonrandomized
trials were also included into the selection because of the methods used by the authors. The early,
simultaneous approach was reported to improve quality of life in two out of 7 papers, symptoms control in 1 out of 5
papers, overall survival in 2 out of 3 papers, quality of care in 5 out of 8 papers, patients’ or caregivers’ satisfaction in 3
out of 4 papers; and to reduce the costs of assistance in 2 out of 3 papers.
Conclusion: Early palliative care improves the main outcomes of the assistance in patients with advanced oncologic and
non-oncologic chronic diseases. The available data are probably enough to consider early palliative cares a novel standard
of care in these groups of patients.