Palliative care for children with central nervous system tumors: results of a Spanish multicenter study
Por:
Pérez-Torres Lobato M, Navarro 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 and Quiroga-Cantero E
Publicada:
1 mar 2024
Ahead of Print:
1 ago 2023
Resumen:
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.
Filiaciones:
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 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.
Quiroga-Cantero E:
Pediatric Oncology Unit, Virgen del Rocio Hospital, Seville, Spain
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