Heidrun Golla, Charlotte Nettekoven, Martin Hellmich, Iris Appelmann, Claudia Bausewein, Gerhild Becker, Christopher Boehlke, T Brumbarova, Daniele Civello, Hans Clusmann, B Haberland, Dieter Henrik Heiland, Ulrich Herrlinger, Birgit Jaspers, Melanie Joshi, D. Mulller, Wiebke Müller, Chuh-Hyoun Na, Martin Neukirchen, Lukas Radbruch, Marion Rapp, Roman Rolke, Maximilian I. Ruge, Michael Sabel, Oliver Schnell, Jacqueline Schwartz, Niklas Thon, Hartmut Vatter, Louisa von Baumgarten, R Voltz, Roland Goldbrunner, the EPCOG Study Group, Auke van Bruggen, Lena Dreher, Katarina Drömer, Isabel Franke, Gina Fürtjes, Stefan Grau, Stefanie Hamacher, Petra Heiden, Stefanie Jünger, Sophia Kochs, Simone Matte, Anna-Katharina Meißner, Patrick Melich, Anne Müller, Irini Papachristou, Daniel Rueß, Catharina Schröter, Franziska Schwartzkopff, Stefanie Stock, Niklas Von Spreckselsen, Imke Bringer, Hilde Cavelius, Daniel Delev, Sonja Hiddemann, Norbert Krumm, Marita Kumschlies, Manuela Langheimer, Christina Thamm, Erdem Güresir, Michaela Hesse, Kirsten Hüning, Christiane Landwehr, Mirco Muscheid, Niklas Schäfer, Christina Schaub, C. Stratmann, Derya Tezel, Berit Zimmer, Nicole Dietrichs, Marcel A. Kamp, Lena Koschnitzke, Natalie Meyer-Sevens, Caterina Quente, Manuela Schallenburger, Marie Schulz, Petra Winter, Melanie Adler, Bianca-Ioana Blaß, Debora Cipriani, J. Daniuk, M. Vernet Tomas, Francisco Gabriel Jiménez-Núñez, Alina Glebova, Pamela Heiland, Junko C Hübers, Nadja Jarc, N. Koch, Bianca Lauble, Márcia Regina Machein, T. van der Meer, Yashar Naseri, Nicolas Neidert, Saskia Opitz, Myriam Peters, Anna Vongerichten, Anja Wiegleb-Brunet, Christoph Barth, Berend Feddersen
BACKGROUND: Positive effects of early integration of palliative care (EIPC) have been shown for systemic solid malignant tumors. We tested the hypothesis that EIPC improves quality of life (QoL), palliative care (PC) problems and mood in glioblastoma patients and reduces caregiver burden. METHODS: This randomized, rater-blinded, controlled trial conducted in six German university medical centers included glioblastoma patients within four weeks after diagnosis (first/recurrent) and their caregivers. Patients received standard care (control) or standard care and EIPC (intervention) for 12 months. Primary outcome was change in QoL after six months measured by the trial outcome index of the FACT-Br. Data were assessed 3-monthly for up to 24 months. RESULTS: Between 05/2019 and 04/2021 patients were enrolled and randomized to the intervention (n = 109) or control group (n = 108). QoL at month six was in favor of the intervention, however not statistically significant (mean difference 4.1 with 95% CI, -4.4 to 12.6, P = .34; intervention: n = 98 (m = 54/f = 44); control: n = 89 (m = 50/f = 39)). In an analysis adjusted for time of death, performed because of a significant survival difference (control superior to intervention, P = .018), QoL was better in the intervention group (P = .041). Secondary outcomes showed that patients significantly benefited from EIPC regarding PC problems and mood especially after intervention ended, while caregivers did not seem to benefit. CONCLUSIONS: Provided that the survival difference is included in the analysis, EIPC improves QoL in glioblastoma patients. This, in addition to improved mood and PC problems, demonstrates that EIPC sustainably improves 'how to live' but not 'length of life'.