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Optimising Palliative Care for Children with Metastatic Neuroblastoma and the Paediatrician's Role in a Shared Care

Manjusha Nair1, Priyakumari Thankamony1, Binitha Rajeswari1

  • 1Department of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.

Indian Journal of Palliative Care
|June 7, 2024
PubMed

Insights

Palliative care (PC) is crucial for children with metastatic neuroblastoma (NB), but access is limited. Early integration of PC services improves care quality for pediatric cancer patients.

Area of Science:

  • Pediatric Oncology
  • Palliative Care
  • Cancer Epidemiology

Background:

  • Metastatic cancer poses a significant burden on children in developing nations.
  • Palliative care (PC) services for pediatric patients are often scarce and underutilized.
  • Neuroblastoma (NB) is a common childhood cancer with advanced stages often requiring palliative support.

Purpose of the Study:

  • To determine the palliative care needs of children diagnosed with metastatic neuroblastoma (NB).
  • To assess the availability and utilization of palliative care services for these pediatric patients.
  • To evaluate the timing and effectiveness of palliative care integration in NB management.

Main Methods:

  • A retrospective analysis of medical records was conducted for children aged 1-14 years diagnosed with metastatic NB.
  • Data were collected over a 10-year period (January 2008 - December 2017).
  • Patient demographics, symptoms, PC consultation details, and outcomes were analyzed.

Main Results:

  • Out of 119 patients with metastatic NB, 87 (73.1%) received PC consultation, with only 14.9% referred early.
  • Pain was the most frequent symptom reported. Care shifted to PC at relapse (66.6%) or end-of-life (18.3%).
  • Common end-of-life symptoms included nausea, vomiting, constipation, and abdominal distension. Median survival was 9 months from diagnosis.

Conclusions:

  • Timely integration of PC services is essential for children with metastatic cancer.
  • Shared care models involving oncology, PC teams, and pediatricians can improve care continuity.
  • Enhanced palliative care provision can significantly improve the quality of life for pediatric cancer patients.
Abstract

Keywords:
Developing countryIndiaMetastatic neuroblastomaPaediatric oncologyPalliative care

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