Introduction: Glioblastoma (GBM) is an aggressive brain tumor with limited treatment options and a poor prognosis, significantly impacting quality of life. Despite treatment advancements, median survival remains only 15 to 20 months. Palliative care (PC) has shown potential to improve quality of life and reduce healthcare costs in cancer, yet it remains underutilized and often initiated too late in GBM. This meta-analysis evaluates the impact of PC on survival, healthcare utilization, and end-of-life (EOL) care in patients with GBM.
Methods: A database search was conducted until October 10, 2024, to identify studies reporting outcomes for patients with GBM receiving PC versus those without. The primary outcomes included overall survival, mortality rates, and healthcare utilization metrics, like outpatient visits, emergency room visits, hospital admissions, ICU admissions, and the provision of aggressive EOL care.
Results: Among 917 articles screened, 6 met inclusion criteria, analyzing 110,386 patients with GBM across 5 retrospective cohorts and 1 propensity score-matched study. PC patients reported significantly more outpatient visits (MD=5.78; 95%CI[2.48,9.07], p=0.0006). Patients receiving PC also experienced a 43% reduction in aggressive EOL care (RR=0.57; 95%CI[0.40,0.82], p=0.002). Furthermore, PC patients were associated with reduced hospital admission rates (RR=0.68; 95%CI[0.51,0.91], p=0.01), ICU admissions (RR=0.72; 95%CI[0.55,0.93], p=0.009), and ER visits (RR=0.74; 95%CI[0.60,0.92], p=0.004). Overall survival was similar between both groups (RR=1.05; 95%CI[0.89, 1.24], p=0.55).
Conclusion : PC in GBM patients significantly reduces aggressive EOL care, including hospitalizations, ICU admissions, and ER visits, while enhancing outpatient support. Although limited by heterogeneity in outcome reporting, these findings highlight PC’s crucial role in optimizing the quality of life for GBM patients. Integrating PC into GBM care is essential to achieving patient-centered, quality-of-life-aligned care. Large, multicenter studies are needed to further validate these results and promote the systematic, timely integration of PC in GBM management.
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