Patients with advanced cancer often face difficult choices and heavy symptom burdens. This study looked at whether a simple change in how care is delivered could make a difference. The researchers focused on patients referred for radiotherapy to treat painful bone metastases. These are spots where cancer has spread to the bones, causing real physical distress. The team compared two groups. One group received a consultation with the hospital palliative care consultation team. The other group received usual care without knowing about the trial. The main goal was to see if patients felt more satisfied with their care. They also checked symptom burden, quality of life, and overall survival. The study followed patients for four weeks. No safety issues or discontinuations were reported because the intervention was a consultation, not a drug. The results are not yet fully reported in this protocol, but the setup aims to show if specialist support helps. This research may provide evidence to support timely integration of specialist palliative care for all patients with bone metastases who may benefit from specialist palliative care.
Palliative care consultation for bone metastases radiotherapy patients shows no outcome data in protocolHospital palliative care teams may improve satisfaction for advanced cancer patients
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Key Takeaway
Consider that this protocol reports no results yet for palliative care consultation in bone metastases.
This study protocol describes a randomized controlled trial in 246 patients referred for hospital radiotherapy for symptomatic bone metastases from advanced cancer. The intervention is consultation with the hospital palliative care consultation team, compared to usual care where the control group was not informed about the trial. The primary outcome is patient satisfaction with care, measured with the EORTC PATSAT-C33 questionnaire at four weeks. Secondary outcomes include symptom burden, quality of life, overall survival, palliative care utilization, and patient experiences with the consultation. No main results are reported in this protocol. Adverse events, serious adverse events, discontinuations, and tolerability are not reported. Key limitations include the lack of reported results and the fact that this is only a protocol. The practice relevance suggests this may provide evidence to support timely integration of specialist palliative care for patients with bone metastases who may benefit, but findings are not yet available.
What this means for you:
Specialist palliative care consultations may improve satisfaction for patients with advanced cancer and bone metastases. More on Cancer
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View Original Abstract ↓
BACKGROUND: Patients living with advanced cancer often benefit from palliative care. Timely referral to specialist palliative care improves quality of life and reduces potentially inappropriate end-of-life care. Despite these benefits, specialist palliative care is frequently introduced late and inconsistently. This study evaluates whether systematically offering a consultation with the hospital palliative care consultation team (PCCT) to all patients referred for radiotherapy for symptomatic bone metastases improves satisfaction with care.
PATIENTS AND METHODS: The Timely Integration of Palliative Care in Oncology care for patients referred for palliative RadioTherapy (TIPZO-RT) trial follows the Trials within Cohorts design and is embedded within the PRospective Evaluation of interventional StudiEs on boNe meTastases (PRESENT+) cohort. Following cohort enrollment, 246 patients will be randomized (1:1) to either the intervention or control group. Patients in the intervention group are offered a PCCT consultation, which they may accept or refrain from. Patients in the control group are not informed about the trial and continue to receive usual care. After four weeks, patient satisfaction with care (affective behavior, EORTC Satisfaction with Cancer Care core questionnaire (EORTC PATSAT-C33)) will be compared between the groups. Secondary outcomes include symptom burden, quality of life, overall survival, and palliative care utilization. Additionally, in the intervention group, patients' experiences with the consultation are evaluated.
DISCUSSION: Integrating palliative care into oncological care for patients with advanced cancer is essential to deliver comprehensive, patient-centered care that addresses physical, psychosocial and spiritual needs. This pragmatic study may provide evidence to support timely integration of specialist palliative care for all patients with bone metastases who may benefit from specialist palliative care. Using the Trials within Cohorts design, this study generates real-world evidence on the acceptance or need for a consultation with the PCCT, while minimizing disappointment or response bias, as patients in the control group are not informed.
TRIAL REGISTRATION: ClinicalTrials.gov ID NCT06805396. Registered on 25-03-2025.
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