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

Autor: Pérez-Torres Lobato M; Division of Pediatric Hematology and Oncology, Vall d'Hebrón Hospital, Pg. de La Vall d'Hebron, 119, 08035, Barcelona, Spain., Navarro-Marchena L; Palliative Care and Complex Chronic Patient Service, Sant Joan de Déu Hospital, Barcelona, Spain., de Noriega I; Pediatric Palliative Care Unit, Niño Jesús Hospital, Madrid, Spain., Morey Olivé M; Division of General Pediatrics, Vall d'Hebrón Hospital, Barcelona, Spain., Solano-Páez P; Pediatric Oncology Unit, Virgen del Rocio Hospital, Seville, Spain., Rubio Pérez E; Methodological and Statistical Management Unit, FISEVI, Virgen del Rocio Hospital, Seville, Spain., Garrido Colino C; Pediatric Oncology Unit, Gregorio Marañon Hospital, Madrid, Spain., García Abos M; Pediatric Oncology Unit, Donostia University Hospital, Donostia, Spain., Tallón García M; Pediatric Oncology Unit, Álvaro Cunqueiro Hospital, Vigo, Spain., Huidobro Labarga B; Palliative Care Unit, Virgen de La Salud Hospital, Toledo, Spain., Portugal Rodríguez R; Pediatric Oncology Unit, Burgos University Hospital, Burgos, Spain., López Ibor B; Pediatric Oncology Unit, Montepríncipe Hospital, Madrid, Spain., Lassaletta Á; Division of Pediatric Hematology and Oncology, Niño Jesús Hospital, Madrid, Spain., Morgenstern Isaak A; Pediatric Palliative Care Unit, Vall d'Hebrón Hospital, Barcelona, Spain., Cruz Martínez O; Division of Pediatric Hematology and Oncology, Pediatric Cancer Center Barcelona, Barcelona, Spain., Valero Arrese L; Division of Pediatric Hematology and Oncology, Vall d'Hebrón Hospital, Pg. de La Vall d'Hebron, 119, 08035, Barcelona, Spain., Llort Sales A; Division of Pediatric Hematology and Oncology, Vall d'Hebrón Hospital, Pg. de La Vall d'Hebron, 119, 08035, Barcelona, Spain., Gros Subias L; Division of Pediatric Hematology and Oncology, Vall d'Hebrón Hospital, Pg. de La Vall d'Hebron, 119, 08035, Barcelona, Spain., Márquez Vega C; Pediatric Oncology Unit, Virgen del Rocio Hospital, Seville, Spain., Moreno L; Division of Pediatric Hematology and Oncology, Vall d'Hebrón Hospital, Pg. de La Vall d'Hebron, 119, 08035, Barcelona, Spain. lucas.moreno@vallhebron.cat., Quiroga-Cantero E; Pediatric Oncology Unit, Virgen del Rocio Hospital, Seville, Spain.
Jazyk: angličtina
Zdroj: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico [Clin Transl Oncol] 2024 Mar; Vol. 26 (3), pp. 786-795. Date of Electronic Publication: 2023 Aug 30.
DOI: 10.1007/s12094-023-03301-7
Abstrakt: Background: Brain 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).
Methods: Retrospective multicenter study between 2010 and 2021, including children from one month to 18 years, who had died of a brain tumor.
Results: 228 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).
Conclusion: Children 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.
(© 2023. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)
Databáze: MEDLINE
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