The ALLAN trial: impact of early home-based palliative care on emergency care and hospitalisation in advanced gastrointestinal cancer patients
Mené sur 118 patients atteints d'un cancer gastro-intestinal de stade avancé, cet essai randomisé analyse l'intérêt, du point de vue du nombre d'hospitalisations et d'admissions aux urgences, d'une intégration précoce des soins palliatifs dans les soins oncologiques standards
Background: Patients with advanced gastrointestinal (GI) cancer experience a high symptom burden which frequently necessitates emergency care. Integration of early home-based specialised palliative care (SPC) with tumour-specific treatments may impact emergency healthcare use.
Methods: At the initiation of palliative chemotherapy, patients with advanced GI cancer were randomised to early home-based SPC integrated with tumour-specific treatment, or tumour-specific treatment with SPC referral when needed. The aim was to compare quality of life in the two groups. Here we present secondary outcomes; number of emergency department visits, hospitalisations, days of inpatient care, the time from the last chemotherapy treatment to death, and the place of death between the study groups.
Results: A total of 118 patients were randomised. Patients in the early SPC group had significantly fewer emergency department visits (median 1 versus 3), hospitalisations (median 1 versus 2), and inpatient care days (median 1.5 vs. 11.5) compared to the control group (p < 0.001). There was no significant difference between the study groups in either time between the last chemotherapy treatment and death, inpatient SPC or place of death.
Conclusion: Early integration of home-based SPC in advanced GI cancer patients significantly reduces emergency healthcare use and hospitalisation.
British Journal of Cancer , article en libre accès, 2026