Journal of Neuro-Oncology

, Volume 108, Issue 3, pp 527–534 | Cite as

Identifying the palliative care needs of patients living with cerebral tumors and metastases: a retrospective analysis

Clinical Study

Abstract

Primary tumors and metastatic involvement of the central nervous system (CNS) lead to a multitude of symptoms and care needs. Patients and caregivers struggle with physical and psychological impairments, a shortened life expectancy and diverse palliative care needs. This study assesses the symptom burden and palliative care needs of patients with primary brain tumors and with metastatic brain tumors requiring inpatient hospital care. It is a retrospective analysis of patients with primary CNS tumors or cerebral metastases over a 6 month period. The data analysed included physical symptom burden and end of life care decisions such as health care proxy, transition to hospice and do-not-resuscitate orders. Hundred and sixty eight patients were included. The most common symptoms were gait impairment (65.5 %), cognitive/personality change (61.9 %), motor deficits (58.3 %), seizures (57.1 %) and delirium (27.4 %). Of the patients that died, 79 % had an appointed health care proxy, 79 % had hospice discussions, 70 % had a do-not-resuscitate order and 24 % received cancer directed therapy in the last month of life. There is a role for more aggressive palliative care support in patients living with primary or metastatic brain tumors.

Keywords

Primary brain tumor Metastatic tumor Palliative care End of life care Clinical neurology 

Notes

Acknowledgments

Thank you to John Francavilla and Kristin Herman for their assistance with the database information. This research was not funded by any granting agency or other funding source.

Conflict of interest

Dr. Gofton and Dr. Graber both receive fellowship funding from Memorial Sloan-Kettering Cancer Center. Dr. Carver has nothing to disclose. No funding was received for this project.

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Copyright information

© Springer Science+Business Media, LLC. 2012

Authors and Affiliations

  • Teneille E. Gofton
    • 1
  • Jerome Graber
    • 2
  • Alan Carver
    • 2
  1. 1.Division of Medicine, Department of Pain and Palliative CareMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of NeurologyMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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