Early Integration of Palliative Care in Pediatric Patients with Central Nervous System Tumors: A Monocentric Experience

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ID: 331986
2026
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Ranked #140 of 144 articles by views in Neuro-Oncology Advances

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Abstract
Abstract Background Central nervous system (CNS) tumors are the most frequent solid neoplasms in pediatric patients. Despite improvements in oncological treatments, morbidity and mortality remain high. Transitioning from oncological care to palliative care (PC) requires an integrated approach. This study aimed to identify the need and implement early shared care for pediatric CNS tumor patients eligible for PC. Methods Pediatric patients with CNS tumors eligible for pediatric palliative care (PPC) were identified early through monthly multidisciplinary meetings between neuro-oncology and palliative care teams. Each case was evaluated using the ACCAPED scale to assess complex requirements and define optimal care intensity. Eligibility for specialized PPC was defined by an ACCAPED score ≥50 Management included scheduled family meetings, Day Hospice access, relief hospitalizations and end-of-life care. Results Forty patients were presented at multidisciplinary meetings; 24 (60%) received integrated neuro-oncological and palliative care. Median age was 7 years (range 3–22). Diagnoses included diffuse midline gliomas (16/24), medulloblastomas (6/24), and atypical teratoid/rhabdoid tumors (2/24). All 24 patients had end-of-life hospitalizations, 30% had accessed the Day Hospice previously, and 10% entered hospice via emergency room. Average hospice stay was 40 days (range 2–190). ACCAPED scores at intake averaged 70 (range 50–80) and increased to 80 (range 70–100) at 4 weeks. Conclusions Early shared neuro-oncological and PC improves quality of life for pediatric CNS tumor patients and their families, reduces emotional burden, and optimizes symptom management, particularly near end-of-life. This integrated model represents a progressive approach in pediatric care, emphasizing early palliative involvement from diagnosis in poor prognosis conditions.
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Authors Antonella Cacchione, Alessandra Pieroni, Alessandro Jenkner, Francesca Cocca, Emanuela Monteferrario, Andrea De Salvo, Giulia Albino, Sebastian Cristaldi, Federica D'Antonio, Luigi Zucaro, Rossana Ruggiero, Giada Del Baldo, Giacomina Megaro, Valentina Di Ruscio, Andrea Carai, Michele Salata, Angela Mastronuzzi
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Journal Neuro-Oncology Advances
Year 2026
DOI
10.1093/noajnl/vdag261
URL
https://doi.org/10.1093/noajnl/vdag261
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