Can adding palliative rehabilitation soon after an advanced cancer diagnosis improve quality of life?

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Early integration of palliative care into oncology treatment is widely recommended. Palliative rehabilitation has been proposed as an approach that integrates enablement, self-management, and self-care into the holistic model of palliative care. The researchers hypothesized that introducing palliative rehabilitation early could improve quality of life.

The Pal-Rehab study (ClinicalTrials.gov NCT02332317) was a randomized controlled trial. At Vejle University Hospital, Denmark, adults diagnosed with advanced cancer within the previous 8 weeks were randomized 1:1 to standard oncology care or standard care plus the intervention. The 12-week intervention, delivered by a specialized palliative care team, included two mandatory consultations and the opportunity to participate in an interdisciplinary group program. Additional individual consultations were offered if needed.

Assessments at baseline, 6 weeks, and 12 weeks used the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30). At baseline, participants chose a “primary problem” from the QLQ-C30 domains. The primary endpoint was change in this patient-selected problem, measured as area under the curve across 12 weeks using T-scores (European mean = 50; SD = 10).

A total of 288 participants were randomized, and 279 were included in the modified intention-to-treat analysis: 146 in the standard care group and 133 in the intervention group. The between-group difference in the primary outcome was 3.0 (95% CI 0.0–6.0; p = 0.047), favoring the intervention.

The researchers concluded that early integration of palliative rehabilitation into standard oncology treatment improved quality of life for patients with newly diagnosed advanced cancer. The trial was registered on ClinicalTrials.gov as NCT02332317 on December 30, 2014.