European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma - 15/06/17

Doi : 10.1016/S1470-2045(17)30345-5

Andrea Pace, MD ^a, Linda Dirven, PhD ^b,^c, Johan A F Koekkoek, MD ^b,^c, Heidrun Golla, MD ^d, Jane Fleming, MD ^e, Roberta Rudà, MD ^f, Christine Marosi, MD ^g, Emilie Le Rhun, MD ^h,ⁱ, Robin Grant, MD ^j, Kathy Oliver, BA ^k, Ingela Oberg, MSc ^l, Helen J Bulbeck, PhD ^m, Alasdair G Rooney, MD ⁿ, Roger Henriksson, ProfMD ^o,^p, H Roeline W Pasman, PhD ^q, Stefan Oberndorfer, ProfMD ^r, Michael Weller, ProfMD ^s, Martin J B Taphoorn, ProfMD ^b,^c,^⁎
for the
European Association of Neuro-Oncology palliative care task force

^a Neuro-Oncology Unit, Regina Elena Cancer Institute, Rome, Italy

^b Department of Neurology, Leiden University Medical Center, Leiden, Netherlands

^c Department of Neurology, Haaglanden Medical Center, The Hague, Netherlands

^d Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany

^e Department of Palliative Medicine, University Hospital Waterford, Waterford, Ireland

^f Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy

^g Department of Internal Medicine I, Clinical Division of Medical Oncology, Medical University of Vienna, Vienna, Austria

^h Neuro-Oncology Unit, Department of Neurosurgery, University Hospital, Lille, France

ⁱ Breast Unit, Department of Medical Oncology, Oscar Lambret Center, Lille, France

^j Edinburgh Centre for Neuro-Oncology, Western General Hospital, Edinburgh, UK

^k International Brain Tumour Alliance, Tadworth, UK

^l Department of Neuroscience, Cambridge University Hospitals, Cambridge, UK

^m brainstrust, Cowes, Isle of Wight, UK

ⁿ Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK

^o Regional Cancer Center Stockholm Gotland, Stockholm, Sweden

^p Department of Radiation Sciences and Oncology, Umeå University, Umeå, Sweden

^q Amsterdam Public Health Research Institute, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands

^r Department of Neurology, University Clinic St Pölten, Karl Landsteiner Private University and Karl Landsteiner Institute for Neurology and Neuropsychology, St Pölten, Austria

^s Department of Neurology, University Hospital, University of Zurich, Zurich, Switzerland

^* Correspondence to: Prof Martin J B Taphoorn, Department of Neurology, Haaglanden Medical Center, 2501 CK, The Hague, Netherlands Department of Neurology Haaglanden Medical Center 2501 CK, The Hague Netherlands

Summary

Patients with glioma present with complex palliative care needs throughout their disease trajectory. The life-limiting nature of gliomas and the presence of specific symptoms related to neurological deterioration necessitate an appropriate and early palliative care approach. The multidisciplinary palliative care task force of the European Association of Neuro-Oncology did a systematic review of the available scientific literature to formulate the best possible evidence-based recommendations for the palliative care of adult patients with glioma, with the aim to reduce symptom burden and improve the quality of life of patients and their caregivers, particularly in the end-of-life phase. When recommendations could not be made because of the scarcity of evidence, the task force either used evidence from studies of patients with systemic cancer or formulated expert opinion. Areas of palliative care that currently lack evidence and thus deserve attention for further research are fatigue, disorders of behaviour and mood, interventions for the needs of caregivers, and timing of advance care planning.

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Plan

Venous thromboembolism

Fatigue

Mood and behavioural disorders

Rehabilitation for neurological deficits

Cognition

Patient and caregiver needs

Patients

Caregivers

Care in the end-of-life phase

Delirium

Nutrition, hydration, and respiration

Advance care planning

Organisation of care in the end-of-life phase

Conclusions

Search strategy and selection criteria

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Vol 18 - N° 6

P. e330-e340 - juin 2017 Retour au numéro

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European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma - 15/06/17

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