Integrated palliative care for patients with advanced head and neck cancer: a retrospective Brazilian cohort study of its impact at the end of life.

OBJECTIVE

To evaluate whether integrated palliative care is associated with improved overall survival and better end-of-life care in patients with upper aerodigestive tract malignancies. Secondary outcomes included the proportion of deaths in the intensive care unit, number of emergency department visits, chemotherapy use in the last 30 days of life, and the need for palliative sedation.

METHODS

This retrospective, non-randomized cohort study included patients with upper aerodigestive tract malignancies who died during a five-year period. Patients were categorized based on whether they received outpatient follow-up by a specialized palliative care team. Healthcare and clinical outcomes were compared between the two groups.

RESULTS

Among the 1,313 consecutive patients, 292 (22.2%) received outpatient palliative care. These patients had a median overall survival 4.7 months longer than those not followed up by palliative care. They also received less chemotherapy in the last 30 days of life, had fewer emergency department visits, had fewer intensive care unit deaths, and required less palliative sedation.

CONCLUSION

Outpatient follow-up by a specialized palliative care team was associated with longer survival and better end-of-life care. These findings highlight the potential benefits of integrating palliative care earlier in the treatment of patients with upper aerodigestive tract cancers.