Palliative and end-of-life care for children with diffuse intrinsic pontine glioma: results from a London cohort study and international survey

Sophie E M Veldhuijzen van Zanten, Charlotte L L I van Meerwijk, Marc H A Jansen, Jos W R Twisk, Anna-Karenia Anderson, Lucy Coombes, Maggie Breen, Olivia J Hargrave, June Hemsley, Finella Craig, Ofelia Cruz, Gertjan J L Kaspers, Dannis G van Vuurden, Darren R Hargrave, SIOPE DIPG Network

Research output: Contribution to journalArticle

Abstract

BACKGROUND: More than 90% of patients with diffuse intrinsic pontine glioma (DIPG) will die within 2 years of diagnosis. Patients deteriorate rapidly during the disease course, which severely impairs their quality of life. To date, no specific research on this clinically important subject has been conducted. This study aimed to compile an inventory of symptoms experienced, interventions applied, and current service provision in end-of-life care for DIPG.

METHODS: We performed a retrospective cohort study of children with DIPG, aged 0-18 years, who received treatment under the care of 2 London hospitals. Symptoms, interventions, and services applied during the 12 weeks before death were analyzed. In addition, we conducted a global questionnaire-study among health care professionals.

RESULTS: In more than 78% of DIPG patients, problems concerning mobility, swallowing, communication, consciousness, and breathing arose during end-stage disease. Supportive drugs were widely prescribed. The use of medical aids was only documented in <15% of patients. Palliative and end-of-life care was mostly based on the health care professional's experience; only 21% of the questionnaire respondents reported to have a disease-specific palliative care guideline available.

CONCLUSIONS: This research assessed the current state of palliative and end-of-life care for children with DIPG. Our results show the variability and complexity of symptoms at end-stage disease and the current lack of disease-specific guidelines for this vulnerable group of patients. This first descriptive paper is intended to act as a solid basis for developing an international clinical trial and subsequent guideline to support high-quality palliative and end-of-life care.

Original languageEnglish
Pages (from-to)582-8
Number of pages7
JournalNeuro-Oncology
Volume18
Issue number4
DOIs
Publication statusPublished - Apr 2016
Externally publishedYes

Keywords

  • Adolescent
  • Brain Stem Neoplasms
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Glioma
  • Humans
  • Infant
  • Infant, Newborn
  • International Agencies
  • London
  • Male
  • Neoplasm Staging
  • Palliative Care
  • Prognosis
  • Quality of Life
  • Retrospective Studies
  • Surveys and Questionnaires
  • Terminal Care
  • Journal Article
  • Research Support, Non-U.S. Gov't

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  • Cite this

    Veldhuijzen van Zanten, S. E. M., van Meerwijk, C. L. L. I., Jansen, M. H. A., Twisk, J. W. R., Anderson, A-K., Coombes, L., Breen, M., Hargrave, O. J., Hemsley, J., Craig, F., Cruz, O., Kaspers, G. J. L., van Vuurden, D. G., Hargrave, D. R., & SIOPE DIPG Network (2016). Palliative and end-of-life care for children with diffuse intrinsic pontine glioma: results from a London cohort study and international survey. Neuro-Oncology, 18(4), 582-8. https://doi.org/10.1093/neuonc/nov250