Optimising Palliative Care for Children with Metastatic Neuroblastoma and the Paediatrician’s Role in a Shared Care Model – Proposal from a Regional Cancer Centre in India

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Indian Journal of Palliative Care Pub Date : 2024-05-22 DOI:10.25259/ijpc_254_2022

M. Nair, Priyakumari Thankamony, B. Rajeswari, C. Guruprasad, V. R. Prasanth, C. V. Prasanth, Kusumakumary Parukkutty

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Abstract

The burden of advanced and metastatic cancer is high among children in developing countries, and palliative care (PC) services for children are sparsely available and poorly accessed. To estimate the burden of PC requirements in children with metastatic neuroblastoma (NB), and to evaluate the PC services offered. Retrospective analysis of case records of children 1–14 years diagnosed with metastatic NB from 1 January 2008 to 31 December 2017. One hundred and nineteen patients with metastatic NB were included, of which 87 patients received PC consultation. Early PC referral occurred only in 13 patients (14.9%), and pain was the most prominent symptom. Shifting of care from oncology to PC occurred at disease relapse in 58 patients (66.6%) and at end-of-life in 16 patients (18.3%). Nausea/vomiting, constipation and abdominal distension were the most common symptoms during end-of-life. Seventy-one patients (85%) died of disease, median time to death being 9 months from diagnosis and 4 months from relapse. The mean time from initiation of PC to death was 4.2 months. Timely integration of PC and shared care incorporating the oncology team, PC team and local paediatricians can ease out transition in care, ensure a continuum of care and improve the quality of treatment delivered to children with metastatic cancer.

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优化转移性神经母细胞瘤患儿的姑息治疗以及儿科医生在共同治疗模式中的作用--印度一家地区癌症中心的建议

在发展中国家，儿童罹患晚期和转移性癌症的比例很高，而针对儿童的姑息治疗（PC）服务却非常稀缺，且难以获得。该研究对2008年1月1日至2017年12月31日期间确诊为转移性神经母细胞瘤（NB）的1-14岁儿童病例记录进行了回顾性分析，纳入了119名转移性NB患者，其中87名患者接受了姑息治疗咨询。只有13名患者（14.9%）接受了PC早期转诊，疼痛是最主要的症状。58名患者（66.6%）在疾病复发时和16名患者（18.3%）在临终时由肿瘤科转诊至内科。恶心/呕吐、便秘和腹胀是临终时最常见的症状。71名患者（85%）死于疾病，中位死亡时间为确诊后9个月和复发后4个月。及时整合肿瘤团队、PC团队和当地儿科医生的PC和共享护理，可以缓解护理过渡，确保护理的连续性，并提高转移性癌症患儿的治疗质量。

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来源期刊

Indian Journal of Palliative Care HEALTH CARE SCIENCES & SERVICES-

CiteScore

2.30

自引率

0.00%

发文量

期刊介绍： Welcome to the website of the Indian Journal of Palliative Care. You have free full text access to recent issues of the journal. The links connect you to •guidelines and systematic reviews in palliative care and oncology •a directory of palliative care programmes in India and IAPC membership •Palliative Care Formulary, book reviews and other educational material •guidance on statistical tests and medical writing.