1 Two Worlds Cancer Collaboration-INCTR Canada , Vancouver, British Columbia, Canada .
2 Pain and Palliative Medicine Department, MNJ Institute of Oncology and Regional Cancer Center , Hyderabad, India .
J Palliat Med. 2018 Jul;21(7):907-912. doi: 10.1089/jpm.2017.0632. Epub 2018 Mar 20.
The primary objective of this study was to describe demographics and end-of-life treatments of children with cancer at a government tertiary cancer center in India.
A retrospective review was undertaken of medical charts of all children younger than 18 years, who died as inpatients while undergoing treatment at the pediatric oncology department between April and September 2016. Data were collected on demographics, diagnosis, treatments, survival, palliative care involvement, and symptoms at end of life.
There were 44 pediatric oncology patients who died in the hospital during the study period. The most frequent diagnoses were hematological malignancies (n = 29). Tumor-specific treatment was given to 38/44 (86%) patients in the last 30 days of life, and 13 patients in the last day of life or 1 day before. Of all deaths, 23/44 (52%) occurred within 30 days of admission to the pediatric ward and 34/44 (77%) within 90 days. Of the 44 patients, 25 (57%) were referred to palliative care. The median number of days between referral and death was 14 (0-78) days. Frequent symptoms documented were bleeding (11/44), dyspnea (10/44), pain (7/44), seizures (7/44), and delirium (5/44), with each patient having one or more of these symptoms. Only patients with a palliative care referral received opioid analgesics or benzodiazepines at the end of life.
This study highlights the demographics of suffering, death, and end-of-life care in children with cancer at a government tertiary cancer center in India.
本研究的主要目的是描述印度一家政府三级癌症中心癌症儿童的人口统计学特征和临终治疗情况。
对 2016 年 4 月至 9 月期间在儿科肿瘤病房住院治疗期间死亡的所有 18 岁以下儿童的病历进行回顾性审查。收集人口统计学、诊断、治疗、生存、姑息治疗参与情况和临终症状的数据。
研究期间，共有 44 名儿科肿瘤患者在医院死亡。最常见的诊断是血液系统恶性肿瘤（n=29）。38/44（86%）名患者在生命的最后 30 天接受了肿瘤特异性治疗，13 名患者在生命的最后一天或前一天接受了治疗。所有死亡中，23/44（52%）发生在儿科病房入院后 30 天内，34/44（77%）发生在 90 天内。44 名患者中，25 名（57%）被转介至姑息治疗。从转介到死亡的中位数天数为 14 天（0-78 天）。记录到的常见症状包括出血（11/44）、呼吸困难（10/44）、疼痛（7/44）、癫痫发作（7/44）和谵妄（5/44），每位患者都有一个或多个这些症状。只有接受姑息治疗转介的患者在生命末期才接受阿片类镇痛药或苯二氮䓬类药物治疗。
本研究强调了印度一家政府三级癌症中心癌症儿童的痛苦、死亡和临终关怀的人口统计学特征。
