End-of-life care in children and adolescents with cancer: perspectives from a French pediatric oncology care network.

Autor:	Blais S; Pediatric Department, Poissy Hospital, Poissy, France., Cohen-Gogo S; Division of Hematology and Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada., Gouache E; Department of Pediatric Hematology, Trousseau Hospital (AP-HP), Sorbonne University, Paris, France., Guerrini-Rousseau L; Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Paris-Saclay University, Villejuif, France., Brethon B; Pediatric Hematology Department, Robert Debré Hospital (AP-HP), Paris, France.; RIFHOP, Île-de-France Regional Network of Pediatric Hematology-Oncology, Paris, France., Rahal I; Adolescents and Young Adults Hematology Department, Saint-Louis Hospital (AP-HP), Paris, France., Petit A; Department of Pediatric Hematology, Trousseau Hospital (AP-HP), Sorbonne University, Paris, France., Raimondo G; Department of Pediatric Hematology and Oncology, Hôpital d'Enfants Margency, Margency, France.; PALIPED, Regional Pediatric Palliative Care Resource Team of Île-de-France, Paris, France., Pellegrino B; Pediatric Department, Poissy Hospital, Poissy, France.; RIFHOP, Île-de-France Regional Network of Pediatric Hematology-Oncology, Paris, France.; PALIPED, Regional Pediatric Palliative Care Resource Team of Île-de-France, Paris, France., Orbach D; RIFHOP, Île-de-France Regional Network of Pediatric Hematology-Oncology, Paris, France.; SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France.
Jazyk:	angličtina
Zdroj:	Tumori [Tumori] 2022 Jun; Vol. 108 (3), pp. 223-229. Date of Electronic Publication: 2021 May 04.
DOI:	10.1177/03008916211013384
Abstrakt:	Background: In developed countries, cancer remains the leading cause of pediatric death from illness after the neonatal period. Objective: To describe the end-of-life care characteristics of children and adolescents with solid tumors (ST) or hematologic malignancies (HM) who died from tumor progression in the Île-de-France area. Methods: This is a regional, multicentric, retrospective review of medical files of all children and adolescents with cancer who died over a 1-year period. Extensive data from the last 3 months of life were collected. Results: A total of 99 eligible patients died at a median age of 9.8 years (range, 0.3-24 years). The most frequent terminal symptoms were pain (n = 86), fatigue (n = 84), dyspnea (n = 49), and anorexia (n = 41). Median number of medications per patient was 8 (range, 3-18). Patients required administration of opioids (n = 91), oxygen (n = 36), and/or sedation (n = 61). Decision for palliative care was present in all medical records and do-not-resuscitate orders in 90/99 cases. Symptom prevalence was comparable between children and adolescents with ST and HM. A wish regarding the place of death had been expressed for 64 patients and could be respected in 42 cases. Death occurred in hospital for 75 patients. Conclusions: This study represents a large and informative cohort illustrating current pediatric palliative care approaches in pediatric oncology. End-of-life remains an active period of care requiring coordination of multiple care teams.
Databáze:	MEDLINE
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