Encarnizamiento terapéutico vs cuidados paliativos en pacientes oncológicos en estado terminal: revisión sistemática

Abstract

Title: Therapeutic Obstinacy vs. Palliative Care in Terminally Ill Cancer Patients: A Systematic Review Objectives: To evaluate therapeutic obstinacy and palliative care in terminally ill cancer patients through a systematic review. Methodology: This systematic review followed the PRISMA 2020 guidelines and applied PICO strategies to compare therapeutic obstinacy versus palliative care in terminally ill cancer patients. Studies published in English and Spanish over the last 5 years were included. The search was conducted in PubMed and WoS (Web of Science), using Health Sciences Descriptors (DeCS)/Medical Subject Headings (MeSH) descriptors and Boolean operators. The risk of bias was assessed using Risk of Bias 2 (RoB 2) and Joanna Briggs Institute (JBI) tools. Results: A total of 14 recent articles published between 2022 and 2025 were included. The main findings objectively and in a balanced manner demonstrated that therapeutic obstinacy significantly reduces quality of life and considerably increases the emotional suffering of patients and their families. Conversely, early palliative care showed benefits in reducing depressive symptoms and promoted a positive environment for both patients and their families. Discussion: The evidence presents inherent limitations related to retrospective observational designs, particularly a potential risk of selection bias, variability in the interventions applied, and a lack of uniformity in the operational definitions used. Conclusions: Therapeutic obstinacy considerably impairs the quality of life and emotional well-being of terminally ill cancer patients, whereas palliative care, especially when implemented early, provides clear benefits in symptomatic and emotional management.