Supportive care and end-of-life issues in brain tumor patients

Malignant Brain Tumors (BT) have a very poor prognosis and natural history of disease is very short, usually less than one year. BT patients present peculiar symptoms that require appropriate palliative treatment: intracranial hypertension, epilepsy, agitation, dysphagia and alteration of consciousness are the most frequent symptoms in the last stage of disease. However, there is a lack of studies specifically addressed on palliative care and end of life (EoL) issues and too many patients do not receive adequate supportive care. This review reports the management of most common symptoms and palliative care in BT patients. End of Life treatment decisions in brain tumor patients present unique features requiring specific approach and include the decisions about nutrition and hydratation of patients in not reversible coma, withholding of steroid treatment and palliative sedation.