The Last 10 Days of Patients With Glioblastoma

Thier, K.; Calabek, Bernadette; Tinchon, Alexander; Grisold, Wolfgang; Oberndorfer, Stefan

doi:10.1177/1049909115609295

Cited by 40 publications

(25 citation statements)

References 22 publications

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“…In a study examining EOL care in HGG patients conducted in three European countries, the authors reported significant contrast in written AD completion, including 46% in Dutch, 37% in British, and only 6% in Austrian patients ( p < 0.001) ( 28 ). Overall, the findings from the included studies in this review showed that around 0–76% of pmBT patients had an AD completed ( 3 , 5 , 17 , 18 , 23 , 26 , 28 , 30 , 31 , 34 ). The nomination of health care proxies ranged from 8 to 77% among the studies ( 3 , 22 , 26 ).…”

Section: Resultsmentioning

confidence: 84%

Advance Care Planning in Patients with Primary Malignant Brain Tumors: A Systematic Review

et al. 2016

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Advance care planning (ACP) is a process of reflection and communication of a person’s future health care preferences, and has been shown to improve end-of-life (EOL) care for patients. The aim of this systematic review is to present an evidence-based overview of ACP in patients with primary malignant brain tumors (pmBT). A comprehensive literature search was conducted using medical and health science electronic databases (PubMed, Cochrane, Embase, MEDLINE, ProQuest, Social Care Online, Scopus, and Web of Science) up to July 2016. Manual search of bibliographies of articles and gray literature search were also conducted. Two independent reviewers selected studies, extracted data, and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program’s appraisal tools. All studies were included irrespective of the study design. A meta-analysis was not possible due to heterogeneity amongst included studies; therefore, a narrative analysis was performed for best evidence synthesis. Overall, 19 studies were included [1 randomized controlled trial (RCT), 17 cohort studies, 1 qualitative study] with 4686 participants. All studies scored “low to moderate” on the methodological quality assessment, implying high risk of bias. A single RCT evaluating a video decision support tool in facilitating ACP in pmBT patients showed a beneficial effect in promoting comfort care and gaining confidence in decision-making. However, the effect of the intervention on quality of life and care at the EOL were unclear. There was a low rate of use of ACP discussions at the EOL. Advance directive completion rates and place of death varied between different studies. Positive effects of ACP included lower hospital readmission rates, and intensive care unit utilization. None of the studies assessed mortality outcomes associated with ACP. In conclusion, this review found some beneficial effects of ACP in pmBT. The literature still remains limited in this area, with lack of intervention studies, making it difficult to identify superiority of ACP interventions in pmBT. More robust studies, with appropriate study design, outcome measures, and defined interventions are required to inform policy and practice.

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Section: Resultsmentioning

confidence: 84%

Advance Care Planning in Patients with Primary Malignant Brain Tumors: A Systematic Review

et al. 2016

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“…Although no single experimental model recapitulates the full diversity of human glioma, insight into the emergence of hyperexcitability and natural history of epileptogenesis in cortical networks, along with the opportunity to link these to specific oncogenic drivers (9), can provide a precision, mechanism-based approach to individualized medical management of this serious tumor comorbidity. Here we show by EEG and cortical imaging of a defined gene variant mouse model of GBM that tumor propagation in an immunocompetent host reveals a steady progression from cortical hyperexcitability with spike discharges to the spontaneous appearance of tonic-clonic seizures, an aggressive stage reached by 65% of hospitalized patients in the final 10 days of life (54). Repeated episodes of cortical SD, hitherto unrecognized in brain tumor models, were captured; their potential proinflammatory effect adds a pathogenic mechanism that may play an amplifying role in progressive hyperexcitability.…”

Section: Discussionmentioning

confidence: 91%

Pathogenesis of peritumoral hyperexcitability in an immunocompetent CRISPR-based glioblastoma model

Hatcher¹,

Yu²,

Meyer³

et al. 2020

Journal of Clinical Investigation

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“…Three papers described symptoms in the first 10 weeks after surgery: 1–6 weeks postoperatively [48], within 30 days postoperatively [53] and within 10 weeks postoperatively [36]. Symptoms in the end-of-life phase were described in three papers, in which the definition of end of life varied from the moment no next lines of established tumor treatment were possible [37] to 3 months and 1 week before death (retrospectively described by proxies and physicians after the patients’ death) [23], and the last 10 days of life [55]. Two papers registered symptoms in all phases of the disease [26, 30].…”

Section: Resultsmentioning

confidence: 99%

Prevalence of symptoms in glioma patients throughout the disease trajectory: a systematic review

et al. 2018

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BackgroundGlioma patients suffer from a wide range of symptoms which influence quality of life negatively. The aim of this review is to give an overview of symptoms most prevalent in glioma patients throughout the total disease trajectory, to be used as a basis for the development of a specific glioma Patient Reported Outcome Measure (PROM) for early assessment and monitoring of symptoms in glioma patients.MethodsA systematic review focused on symptom prevalence in glioma patients in different phases of disease and treatment was performed in MEDLINE, CINAHL and EMBASE according to PRISMA recommendations. We calculated weighted means for prevalence rates per symptom.ResultsThe search identified 2.074 unique papers, of which 32 were included in this review. In total 25 symptoms were identified. The ten most prevalent symptoms were: seizures (37%), cognitive deficits (36%), drowsiness (35%), dysphagia (30%), headache (27%), confusion (27%), aphasia (24%), motor deficits (21%), fatigue (20%) and dyspnea (20%).ConclusionsEight out of ten of the most prevalent symptoms in glioma patients are related to the central nervous system and therefore specific for glioma. Our findings emphasize the importance of tailored symptom care for glioma patients and may aid in the development of specific PROMs for glioma patients in different phases of the disease.Electronic supplementary materialThe online version of this article (10.1007/s11060-018-03015-9) contains supplementary material, which is available to authorized users.

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The Last 10 Days of Patients With Glioblastoma

Cited by 40 publications

References 22 publications

Advance Care Planning in Patients with Primary Malignant Brain Tumors: A Systematic Review

Advance Care Planning in Patients with Primary Malignant Brain Tumors: A Systematic Review

Pathogenesis of peritumoral hyperexcitability in an immunocompetent CRISPR-based glioblastoma model

Prevalence of symptoms in glioma patients throughout the disease trajectory: a systematic review

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