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End of life care in children and adolescents with cancer: perspectives from a French pediatric oncology care network

Abstract : Background: In developed countries, cancer remains the leading cause of pediatric death from illness after the neonatal period. Objective: To describe the end-of-life care characteristics of children and adolescents with solid tumors (ST) or hematologic malignancies (HM) who died from tumor progression in the Île-de-France area. Methods: This is a regional, multicentric, retrospective review of medical files of all children and adolescents with cancer who died over a 1-year period. Extensive data from the last 3 months of life were collected. Results: A total of 99 eligible patients died at a median age of 9.8 years (range, 0.3–24 years). The most frequent terminal symptoms were pain (n = 86), fatigue (n = 84), dyspnea (n = 49), and anorexia (n = 41). Median number of medications per patient was 8 (range, 3–18). Patients required administration of opioids (n = 91), oxygen (n = 36), and/or sedation (n = 61). Decision for palliative care was present in all medical records and do-not-resuscitate orders in 90/99 cases. Symptom prevalence was comparable between children and adolescents with ST and HM. A wish regarding the place of death had been expressed for 64 patients and could be respected in 42 cases. Death occurred in hospital for 75 patients. Conclusions: This study represents a large and informative cohort illustrating current pediatric palliative care approaches in pediatric oncology. End-of-life remains an active period of care requiring coordination of multiple care teams.
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Submitted on : Monday, July 12, 2021 - 11:40:07 AM
Last modification on : Tuesday, July 20, 2021 - 5:32:33 PM

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Sarah Cohen-Gogo, Elodie Gouache, Lea Guerrini-Rousseau, Benoit Brethon, Ilhem Rahal, et al.. End of life care in children and adolescents with cancer: perspectives from a French pediatric oncology care network. Tumori, Casa Editrice Ambrosiana, 2021, pp.030089162110133. ⟨10.1177/03008916211013384⟩. ⟨hal-03283885⟩

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