End-of-Life Inpatient Palliative Care for Glioblastoma Multiforme: Lessons Learned from One Case

Zhi-Yuan Xiao; Yan-Xia Sun; Dong-Rui Xu; Xiao-Hong Ning; Yu Wang; Yi Zhang; Wen-Bin Ma

doi:10.24920/004394

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End-of-Life Inpatient Palliative Care for Glioblastoma Multiforme: Lessons Learned from One Case

Chinese Medical Sciences Journal Vol. 39, Issue 4, Pages: 297-302(2024)

Case Report | Updated：2025-03-07

- End-of-Life Inpatient Palliative Care for Glioblastoma Multiforme: Lessons Learned from One Case
- Affiliations：
  
  1.Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  2.Palliative Care Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
  
  Yi Zhang, E-mail: zhangyi780621@sina.com
  Wen-Bin Ma, E-mail: mawb2001@hotmail.com
- Funds：
- DOI：10.24920/004394
  CLC：
- Received：02 July 2024，
  
  Accepted：2024-09-14，
  
  Published Online：03 November 2024，
  
  Published：31 December 2024
- Accepted：
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肖志源,孙燕霞,许冬蕊等.多形性胶质母细胞瘤住院患者的生命末期缓和医疗照护：一例的经验[J].中国医学科学杂志（英文）,2024,39(04):297-302.

Xiao Zhi-Yuan,Sun Yan-Xia,Xu Dong-Rui,et al.End-of-Life Inpatient Palliative Care for Glioblastoma Multiforme: Lessons Learned from One Case[J].Chinese Medical Sciences Journal,2024,39(04):297-302.
肖志源,孙燕霞,许冬蕊等.多形性胶质母细胞瘤住院患者的生命末期缓和医疗照护：一例的经验[J].中国医学科学杂志（英文）,2024,39(04):297-302. DOI： 10.24920/004394.

Xiao Zhi-Yuan,Sun Yan-Xia,Xu Dong-Rui,et al.End-of-Life Inpatient Palliative Care for Glioblastoma Multiforme: Lessons Learned from One Case[J].Chinese Medical Sciences Journal,2024,39(04):297-302. DOI： 10.24920/004394.

摘要

多形性胶质母细胞瘤（glioblastoma multiforme，GBM）是最常见的恶性原发性脑肿瘤，预后差，生存期有限。GBM患者对缓和医疗具有很高的需求。在本病例中，我们为一名21岁女性GBM患者在生命末期提供了住院缓和医疗服务，包括症状管理、精神和心理支持；向其家庭成员提供了社会心理和临床决策支持，并在患者离世后给予丧亲管理。此外，我们还为家属提供了全面的临终心理准备，并协助家属度过哀伤期。本研究旨在为恶性脑肿瘤患者缓和医疗的临床实施提供借鉴和参考。

Abstract

Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor with a poor prognosis and limited survival. Patients with GBM have a high demand for palliative care. In our present case

a 21-year-old female GBM patient received inpatient palliative care services including symptom management

mental and psychological support for the patient

psychosocial and clinical decision support for her family members

and pre- and post-death bereavement management for the family. Furthermore

we provided the family members with comprehensive psychological preparation for the patient's demise and assisted the patient's family throughout the mourning period.The aim of this study is to provide a reference and insights for the clinical implementation of palliative care for patients with malignant brain tumors.

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Louis DN , Perry A , Wesseling P , et al . The 2021 WHO classification of tumors of the central nervous system: a summary . Neuro Oncol 2021 ; 23 ( 8 ): 1231 - 51 . doi: 10.1111/bpa.13060 http://dx.doi.org/10.1111/bpa.13060 .

Luo C , Song K , Wu S , et al . The prognosis of glioblastoma: a large, multifactorial study . Br J Neurosurg 2021 ; 35 ( 5 ): 555 - 61 . doi: 10.1080/02688697.2021.1907306 http://dx.doi.org/10.1080/02688697.2021.1907306 .

Stylli SS . Novel treatment strategies for glioblastoma . Cancers (Basel) 2020 ; 12 ( 10 ): 2883 . doi: 10.3390/cancers12102883 http://dx.doi.org/10.3390/cancers12102883 .

Gritsch S , Batchelor TT , Gonzalez Castro LN . Diagnostic, therapeutic, and prognostic implications of the 2021 World Health Organization classification of tumors of the central nervous system . Cancer 2022 ; 128 ( 1 ): 47 - 58 . doi: 10.1002/cncr.33918 http://dx.doi.org/10.1002/cncr.33918 .

Stupp R , Brada M , van den Bent MJ , Tonn JC , et al . ESMO Guidelines Working Group . High-grade glioma : ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014 ; 25 ( Suppl 3 ): iii93 - 101 . doi: 10.1093/annonc/mdu050 http://dx.doi.org/10.1093/annonc/mdu050 .

Huang B , Li X , Li Y , et al . Current immunotherapies for glioblastoma multiforme . Front Immunol 2021 ; 11 : 603911 . doi: 10.3389/fimmu.2020.603911 http://dx.doi.org/10.3389/fimmu.2020.603911 .

Chen R , Cohen AL , Colman H . Targeted therapeutics in patients with high-grade gliomas: past, present, and future . Curr Treat Options Oncol 2016 ; 17 ( 8 ): 42 . doi: 10.1007/s11864-016-0418-0 http://dx.doi.org/10.1007/s11864-016-0418-0 .

Liu EK , Sulman EP , Wen PY , et al . Novel therapies for glioblastoma . Curr Neurol Neurosci Rep 2020 ; 20 ( 7 ): 19 . doi: 10.1007/s11910-020-01042-6 http://dx.doi.org/10.1007/s11910-020-01042-6 .

Rominiyi O , Vanderlinden A , Clenton SJ , et al . Tumour treating fields therapy for glioblastoma: current advances and future directions . Br J Cancer 2021 ; 124 ( 4 ): 697 - 709 . doi: 10.1038/s41416-020-01136-5 http://dx.doi.org/10.1038/s41416-020-01136-5 .

Liu P , Wang Y , Wang Y , et al . Effects of oncolytic viruses and viral vectors on immunity in glioblastoma . Gene Ther 2022 ; 29 ( 3-4 ): 115 - 26 . doi: 10.1038/s41434-020-00207-9 http://dx.doi.org/10.1038/s41434-020-00207-9 .

Witthayanuwat S , Pesee M , Supaadirek C , et al . Survival analysis of glioblastoma multiforme . Asian Pac J Cancer Prev 2018 ; 19 ( 9 ): 2613 - 7 . doi: 10.22034/APJCP.2018.19.9.2613 http://dx.doi.org/10.22034/APJCP.2018.19.9.2613 .

Meissen H , Gong MN , Wong AI , et al . The future of critical care: optimizing technologies and a learning healthcare system to potentiate a more humanistic approach to critical care . Crit Care Explor 2022 ; 4 ( 3 ): e0659 . doi: 10.1097/CCE.0000000000000659 http://dx.doi.org/10.1097/CCE.0000000000000659 .

Chung H , Harding R , Guo P . Palliative care in the Greater China region: a systematic review of needs, models, and outcomes . J Pain Symptom Manage 2021 ; 61 ( 3 ): 585 - 612 . doi: 10.1016/j.jpainsymman http://dx.doi.org/10.1016/j.jpainsymman .

Hui D , Bruera E . Models of palliative care delivery for patients with cancer . J Clin Oncol 2020 ; 38 ( 9 ): 852 - 65 . doi: 10.1200/JCO.18.02123 http://dx.doi.org/10.1200/JCO.18.02123 .

Wee B . Models of delivering palliative and end-of-life care in the UK . Curr Opin Support Palliat Care 2013 ; 7 ( 2 ): 195 - 200 . doi: 10.1097/SPC.0b013e328361570a http://dx.doi.org/10.1097/SPC.0b013e328361570a .

Vanbutsele G , van Belle S , Surmont V , et al . The effect of early and systematic integration of palliative care in oncology on quality of life and health care use near the end of life: a randomised controlled trial . Eur J Cancer 2020 ; 124 : 186 - 93 . doi: 10.1016/j.ejca.2019.11.009 http://dx.doi.org/10.1016/j.ejca.2019.11.009 .

Srinivasan VJ , Akhtar S , Huppertz JW , et al . Prospective cohort study on the impact of early versus late inpatient palliative care on length of stay and cost of care . Am J Hosp Palliat Care 2023 : 10499091231152609 . doi: 10.1177/10499091231152609 http://dx.doi.org/10.1177/10499091231152609 .

Byrne A , Torrens-Burton A , Sivell S , et al . Early palliative interventions for improving outcomes in people with a primary malignant brain tumour and their carers . Cochrane Database Syst Rev 2022 ; 1 (1): CD013440. doi: 10.1002/14651858.CD013440.pub2 http://dx.doi.org/10.1002/14651858.CD013440.pub2 .

Golla H , Nettekoven C , Bausewein C , et al ; EPCOG study group . Effect of early palliative care for patients with glioblastoma (EPCOG): a randomised phase III clinical trial protocol . BMJ Open 2020 ; 10 ( 1 ): e034378 . doi: 10.1136/bmjopen-2019-034378 http://dx.doi.org/10.1136/bmjopen-2019-034378 .

Ferrell BR , Temel JS , Temin S , et al . Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical practice guideline update . J Clin Oncol 2017 ; 35 ( 1 ): 96 - 112 . doi: 10.1200/JCO.2016.70.1474 http://dx.doi.org/10.1200/JCO.2016.70.1474 .

Sizoo EM , Braam L , Postma TJ , et al . Symptoms and problems in the end-of-life phase of high-grade glioma patients . Neuro Oncol 2010 ; 12 ( 11 ): 1162 - 6 . doi: 10.1093/neuonc/nop045 http://dx.doi.org/10.1093/neuonc/nop045 .

Tatum PE . End-of-Life Care: Hospice Care . FP Essent . 2020 Nov ; 498 : 26 - 31 .

Armstrong TS , Vera-Bolanos E , Acquaye AA , et al . The symptom burden of primary brain tumors: evidence for a core set of tumor- and treatment-related symptoms . Neuro Oncol 2016 ; 18 ( 2 ): 252 - 60 . doi: 10.1093/neuonc/nov166 http://dx.doi.org/10.1093/neuonc/nov166 .

Koekkoek JA , Dirven L , Sizoo EM , et al . Symptoms and medication management in the end of life phase of high-grade glioma patients . J Neurooncol 2014 ; 120 ( 3 ): 589 - 95 . doi: 10.1007/s11060-014-1591-2 http://dx.doi.org/10.1007/s11060-014-1591-2 .

WHO . WHO definition of palliative care ( 2018 ) [EB/OL ] . Available at www.who.int/cancer/palliative/definition/en. www.who.int/cancer/palliative/definition/en. Accessed December 6 , 2021 .

International Association For Hospice & Palliative Care . IAHPC Projects: Consensus-Based Definition of Palliative Care ( 2019 )[EB/OL ] . Available at https:// hospicecare. com/ what-we-do/ projects/ consensus-based-definition-of-palliative-care/. https://hospicecare.com/what-we-do/projects/consensus-based-definition-of-palliative-care/. Accessed November 1 , 2024 .

Walbert T , Khan M . End-of-life symptoms and care in patients with primary malignant brain tumors: a systematic literature review . J Neurooncol 2014 Apr ; 117 ( 2 ): 217 - 24 . doi: 10.1007/s11060-014-1393-6 http://dx.doi.org/10.1007/s11060-014-1393-6 .

Thier K , Calabek B , Tinchon A , et al . The last 10 days of patients with glioblastoma: assessment of clinical signs and symptoms as well as treatment . Am J Hosp Palliat Care 2016 ; 33 ( 10 ): 985 - 88 . doi: 10.1177/1049909115609295 http://dx.doi.org/10.1177/1049909115609295

Pace A , Dirven L , Koekkoek JAF , et al ; European Association of Neuro-Oncology palliative care task force . European Association of Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma . Lancet Oncol 2017 ; 18 ( 6 ): e330 - 40 . doi: 10.1016/S1470-2045(17)30345-5 http://dx.doi.org/10.1016/S1470-2045(17)30345-5 .

Koekkoek JAF , van der Meer PB , Pace A , et al . Palliative care and end-of-life care in adults with malignant brain tumors . Neuro Oncol 2022 : noac216 . doi: 10.1093/neuonc/noac216 http://dx.doi.org/10.1093/neuonc/noac216 .

Walbert T , Stec NE . Palliative care in brain tumors . Handb Clin Neurol 2023 ; 191 : 69 - 80 . doi: 10.1016/B978-0-12-824535-4.00011-2 http://dx.doi.org/10.1016/B978-0-12-824535-4.00011-2 .

Oberndorfer S , Hutterer M . Palliative care in glioma management . Curr Opin Oncol 2019 ; 31 ( 6 ): 548 - 53 . doi: 10.1097/CCO.0000000000000584 http://dx.doi.org/10.1097/CCO.0000000000000584 .

Xiao Z , Chen W , Zhao H , et al . Palliative care for patients with glioma: A recent scientometric analysis of the Web of Science in 2022 . Front Oncol 2022 ; 12 : 995639 . doi: 10.3389/fonc.2022.995639 http://dx.doi.org/10.3389/fonc.2022.995639 .

Kwak J , Haley WE . Current research findings on end-of-life decision making among racially or ethnically diverse groups . Gerontologist 2005 ; 45 ( 5 ): 634 - 41 . doi: 10.1093/geront/45.5.634 http://dx.doi.org/10.1093/geront/45.5.634 .

Chu LW , Luk JK , Hui E , et al . Advance directive and end-of-life care preferences among Chinese nursing home residents in Hong Kong . J Am Med Dir Assoc 2011 ; 12 ( 2 ): 143 - 52 . doi: 10.1016/j.jamda.2010.08.015 http://dx.doi.org/10.1016/j.jamda.2010.08.015 .

Yin Z , Li J , Ma K , et al . Development of palliative care in China: a tale of three cities . Oncologist 2017 ; 22 ( 11 ): 1362 - 67 . doi: 10.1634/theoncologist http://dx.doi.org/10.1634/theoncologist .

Pompili A , Telera S , Villani V , et al . Home palliative care and end of life issues in glioblastoma multiforme: results and comments from a homogeneous cohort of patients . Neurosurg Focus 2014 ; 37 ( 6 ): E5 . doi: 10.3171/2014.9.FOCUS14493 http://dx.doi.org/10.3171/2014.9.FOCUS14493 .

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