{
  "abstract": "Palliative care integrated with standard oncology treatment improves symptoms, quality of life and communication, and may extend survival in select populations. However, its integration into routine oncology practice remains inconsistent, delayed and unequal. This review critically approaches international guidelines on integrating palliative care into oncology, outlines critical gaps in referral timing, triggers, team composition, haematologic malignancies and resource stratification, and translates recommendations into practical service-delivery models and implementation strategies. Meta-analyses, randomised controlled trials and guidelines collectively advocate for early, concurrent palliative care, delivered by interdisciplinary teams with primary palliative care skills within oncology. However, key gaps persist in referral triggers, service standards, resource-stratified pathways and performance metrics, particularly for haematologic malignancies, caregivers and underserved populations. Crucially, we detail how workforce shortages, inequitable opioid access and financing gaps create predictable disparities for paediatric, rural, low-income and minority populations, and propose practical, resource-stratified adaptations for each barrier. Real-world programmes show promise in multiple delivery models, but scaling these models is limited by workforce shortages, funding, opioid access and infrastructure. This work additionally synthesises evidence on the integration of palliative care in oncology care across different continents and countries. The focus now must shift from demonstrating palliative care’s benefits to ensuring equitable, timely delivery through clear referral triggers, strengthened primary palliative care, sustainable funding and measurable quality indicators.",
  "authors": [
    {
      "affiliations": [
        "Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece",
        "University Hospital and University of Crete, School of Medicine, Heraklion, Greece"
      ],
      "name": "Dimitrios Stylianakis"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Thessaly, Larisa, Greece"
      ],
      "name": "Vasiliki Bampiolaki"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Thessaly, Larisa, Greece"
      ],
      "name": "Konstantinos Grigoriou"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia"
      ],
      "name": "Maria Vasilopoulou"
    },
    {
      "affiliations": [
        "University Hospital and University of Crete, School of Medicine, Heraklion, Greece"
      ],
      "name": "Ioannis Stylianakis"
    },
    {
      "affiliations": [
        "Aristotle University of Thessaloniki, Faculty of Medicine, Thessaloniki, Greece"
      ],
      "name": "Christos Tsagkaris"
    },
    {
      "affiliations": [
        "Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy"
      ],
      "name": "Serafina Martella"
    },
    {
      "affiliations": [
        "Palliative Care Unit(Pain Therapy and Palliative Care), Ospedale Sirai, Carbonia(ASL Sulcis), Italy"
      ],
      "name": "Denise Vacca"
    },
    {
      "affiliations": [
        "Medical Oncology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy"
      ],
      "name": "Nerina Denaro"
    },
    {
      "affiliations": [
        "Azienda ASL Cagliari, Cagliari, Italy"
      ],
      "name": "Mariangela Cogoni"
    },
    {
      "affiliations": [
        "Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari/Monserrato, Italy"
      ],
      "name": "Fabiana Melis"
    },
    {
      "affiliations": [
        "Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece"
      ],
      "name": "Marios Spanakis"
    },
    {
      "affiliations": [
        "Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece"
      ],
      "name": "Emmanouil Symvoulakis"
    },
    {
      "affiliations": [
        "Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari/Monserrato, Italy"
      ],
      "name": "Giorgio Astara"
    },
    {
      "affiliations": [
        "Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari/Monserrato, Italy"
      ],
      "name": "Mario Scartozzi"
    },
    {
      "affiliations": [
        "Medical Oncology, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy"
      ],
      "name": "Raffaele Giusti"
    },
    {
      "affiliations": [
        "Medical Oncology Unit, University Hospital of Cagliari, Cagliari/Monserrato, Italy"
      ],
      "name": "Cinzia Solinas"
    }
  ],
  "title": "Palliative care integration in oncology: narrative review",
  "uid": "19995f99-2d28-5e90-8189-93036e6dfcf6"
}