Palliative radiotherapy for pediatric patients: Parental perceptions of indication, intent, and outcomes.

Autor: Lee BK; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.; Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, California., Boyle PJ; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts., Zaslowe-Dude C; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts., Wolfe J; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.; Radiation Oncology Department, Brigham and Women's Hospital, Boston, Massachusetts., Marcus KJ; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.; Radiation Oncology Department, Brigham and Women's Hospital, Boston, Massachusetts.; Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2020 Jan; Vol. 67 (1), pp. e28003. Date of Electronic Publication: 2019 Oct 04.
DOI: 10.1002/pbc.28003
Abstrakt: Objectives: Palliative radiation therapy (pRT) is often used to improve quality of life for pediatric patients. Though palliative doses are generally lower than those for cure, pRT may still introduce undesirable effects. The decision to pursue additional therapy for a child may be challenging and depends on parents' knowledge and expectations. The goal of this study was to explore parental perceptions of pRT.
Methods: Twenty-eight children referred for pRT were enrolled in our prospective study. Parents were counseled regarding the indication and expected outcomes. They then completed a series of questionnaires to assess their understanding of pRT, side effects that their child experienced, and how the outcomes compared to their expectations.
Results: The majority of parents listed pain relief and addressing new disease as the main indication for pRT. When asked about expectations, the majority chose improvement in quality of life and prolongation of their child's life. Interestingly, 32% of parents expected pRT to cure their child's disease. Most patients undergoing pRT did not experience any adverse symptoms. The outcomes of pRT in the majority of cases exceeded parental expectations.
Conclusion: Improved quality of life with pRT sometimes blurs the distinction between palliation and cure. We found that most parents understand the aim to improve quality of life, although a proportion of parents perceived pRT as a cure to their child's disease. Despite this, the majority of parents reported that the outcome of the pRT course exceeded their expectations. We postulate that parents derive comfort from pursuing active treatment.
(© 2019 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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