Palliative care for children with central nervous system tumors: results of a Spanish multicenter study

BackgroundBrain tumors represent the most common cause of cancer-related death in children. Few studies concerning the palliative phase in children with brain tumors are available.Objectives(i) To describe the palliative phase in children with brain tumors; (ii) to determine whether the use of palli...

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Detalles Bibliográficos
Autores: Pérez-Torres Lobato M, Navarro-Marchena L, de Noriega I, Morey Olivé M, Solano-Páez P, Rubio Pérez E, Garrido Colino C, García Abos M, Tallón García M, Huidobro Labarga B, Portugal Rodríguez R, López Ibor B, Lassaletta Á, Morgenstern Isaak A, Cruz Martínez O, Valero Arrese L, Llort Sales A, Gros Subias L, Márquez Vega C, Moreno L, Quiroga-Cantero E
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p24874
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=24874
Access Level:acceso abierto
Palabra clave:End-of-life
Palliative
Brain tumor
CNS tumor
Neuro-oncology
Childhood cancer
Descripción
Sumario:BackgroundBrain tumors represent the most common cause of cancer-related death in children. Few studies concerning the palliative phase in children with brain tumors are available.Objectives(i) To describe the palliative phase in children with brain tumors; (ii) to determine whether the use of palliative sedation (PS) depends on the place of death, the age of the patient, or if they received specific palliative care (PC).MethodsRetrospective multicenter study between 2010 and 2021, including children from one month to 18 years, who had died of a brain tumor.Results228 patients (59.2% male) from 10 Spanish institutions were included. Median age at diagnosis was 5 years (IQR 2-9) and median age at death was 7 years (IQR 4-11). The most frequent tumors were medulloblastoma (25.4%) and diffuse intrinsic pontine glioma (DIPG) (24.1%). Median number of antineoplastic regimens were 2 (range 0-5 regimens). During palliative phase, 52.2% of the patients were attended by PC teams, while 47.8% were cared exclusively by pediatric oncology teams. Most common concerns included motor deficit (93.4%) and asthenia (87.5%) and communication disorders (89.8%). Most frequently prescribed supportive drugs were antiemetics (83.6%), opioids (81.6%), and dexamethasone (78.5%). PS was administered to 48.7% patients. Most of them died in the hospital (85.6%), while patients who died at home required PS less frequently (14.4%) (p = .01).ConclusionChildren dying from CNS tumors have specific needs during palliative phase. The optimal indication of PS depended on the center experience although, in our series, it was also influenced by the place of death.

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