Supportive Care in Cancer

, Volume 26, Issue 1, pp 61–79 | Cite as

The impact of specialized palliative care on cancer patients’ health-related quality of life: a systematic review and meta-analysis

  • Angelos P. KassianosEmail author
  • Myria Ioannou
  • Marianna Koutsantoni
  • Haris Charalambous
Review Article



Specialized palliative care (SPC) is currently underutilized or provided late in cancer care. The aim of this systematic review and meta-analysis is to critically evaluate the impact of SPC on patients’ health-related quality of life (HRQoL).


Five databases were searched through June 2016. Randomized controlled trials (RCTs) and prospective studies using a pre- and post- assessment of HRQoL were included. The PRISMA reporting statement was followed. Criteria from available checklists were used to evaluate the studies’ quality. A meta-analysis followed using random-effect models separately for RCTs and non-RCTs.


Eleven studies including five RCTs and 2939 cancer patients published between 2001 and 2014 were identified. There was improved HRQoL in patients with cancer following SPC especially in symptoms like pain, nausea, and fatigue as well as improvement of physical and psychological functioning. Less or no improvements were observed in social and spiritual domains. In general, studies of inpatients showed a larger benefit from SPC than studies of outpatients whereas patients’ age and treatment duration did not moderate the impact of SPC. Methodological shortcomings of included studies include high attrition rates, low precision, and power and poor reporting of control procedures.


The methodological problems and publication bias call for higher-quality studies to be designed, funded, and published. However, there is a clear message that SPC is multi-disciplinary and aims at palliation of symptoms and burden in line with current recommendations.


Palliative care Specialized palliative care Cancer Quality of life Meta-analysis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

520_2017_3895_MOESM1_ESM.docx (29 kb)
ESM 1 (DOCX 28 kb).


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Angelos P. Kassianos
    • 1
    Email author
  • Myria Ioannou
    • 2
  • Marianna Koutsantoni
    • 2
  • Haris Charalambous
    • 3
  1. 1.Department of Applied Health ResearchUniversity College LondonLondonUK
  2. 2.Department of PsychologyUniversity of CyprusNicosiaCyprus
  3. 3.Bank of Cyprus Oncology CentreNicosiaCyprus

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