Aim: This systematic review aimed to summarise characteristics and models of palliative care interventions used in lung cancer populations and compare patient-reported outcomes associated with early versus standard or later integration of palliative care.
Background: Lung cancer is associated with high mortality and substantial physical, psychological and functional burden. Early palliative care is recommended for patients with advanced cancer, yet interventions vary widely in timing, structure, delivery and integration with oncology care. This review examined palliative care models in lung cancer and their impact on patient-reported outcomes.
Methods: A systematic review was conducted in accordance with PRISMA 2020 and registered with PROSPERO. Medline, Embase, PsycINFO, CINAHL and Scopus were searched for randomised controlled trials evaluating palliative care interventions in adults with lung cancer. Eligible studies compared palliative care with standard or usual care and reported patient-reported outcomes, including quality of life, physical, emotional, social or functional well-being. Risk of bias was assessed using RoB 2, and results were synthesised narratively.
Results: Eleven randomised controlled trials were included. Most studies focused on advanced or metastatic lung cancer and introduced palliative care within 1–8 weeks of diagnosis or enrolment. Intervention models included integrated multidisciplinary palliative care, holistic MDT models, nurse-led care, stepped-care approaches and targeted supportive care. Patient-reported outcomes were mixed. More consistent improvements were observed in studies with structured, multidimensional and multidisciplinary interventions, particularly those incorporating regular assessment, psychosocial care and proactive symptom management. Studies with limited MDT involvement, narrow symptom focus, low baseline symptom burden or crossover to palliative care in control groups showed weaker or non-significant effects.
Conclusion: Early palliative care may improve outcomes for patients with lung cancer, but effectiveness appears to depend on the comprehensiveness and structure of the intervention. Optimal models should combine early referral with multidisciplinary care, regular follow-up, psychosocial support and proactive symptom management.