Evidence map›Paper›PMID 36271873›Full record

SynthesisNeuro-oncology2023

Palliative care and end-of-life care in adults with malignant brain tumors.

Johan A F Koekkoek, Pim B van der Meer, Andrea Pace, Caroline Hertler, Rebecca Harrison, Heather E Leeper, Deborah A Forst, Rakesh Jalali, Kathy Oliver, Jennifer Philip and 3 more

Erratum issuedOpen access · greenAbstract readSystematic Review
In one paragraph

Synthesis in Neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 48 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 3 pooled it
9.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 73 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Post-recurrence management of malignant glial brain tumors: therapeutic strategies, evidence and limitations, palliative care, terminal sedation, and end-of-life considerations.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
  5. Management of glioblastoma in the elderly.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Article
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  11. Review
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  13. Pain at the end of life in patients with cancer: a population-based study on prevalence, relief, and the role of pain assessment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  14. Article
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  16. Article
  17. Article
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  19. Living with brain metastasis - a qualitative study of patients' and family members' coping strategies.International journal of qualitative studies on health and well-being · 2025
    Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 9 institutions in 7 countries.

Johan A F KoekkoekDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Pim B van der MeerDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Andrea PaceNeuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Caroline HertlerCompetence Center Palliative Care, Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID 0000-0001-6181-2895
Rebecca HarrisonDivision of Medical Oncology, BC Cancer, The University of British Colombia, Vancouver, Canada.
Heather E LeeperNeuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland,USA.
Deborah A ForstDivision of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA.
Rakesh JalaliDepartment of Radiation Oncology, Apollo Proton Cancer Center, Chennai, India.
Kathy OliverInternational Brain Tumour Alliance, Tadworth, UK.
Jennifer PhilipDepartment of Medicine, St. Vincent's Hospital Melbourne, University of Melbourne, Victoria, Australia.
Martin J B TaphoornDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0001-9949-4722
Linda DirvenDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0001-9157-9895
Tobias WalbertDepartment of Neurology and Neurosurgery, Henry Ford Health System and Department of Neurology Wayne State University, Detroit, Michigan, USA.ORCID 0000-0003-0667-8106
Leiden University Medical Center · NLApollo Proton Cancer Centre · INBrain Tumour Charity · GBHenry Ford Health System · USIstituti di Ricovero e Cura a Carattere Scientifico · ITMassachusetts General Hospital · USNational Institutes of Health · USThe University of Melbourne · AUUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis systematic review provides updated insights, from the published literature in the past 5 years, based on the 2017 European Association of Neuro-Oncology (EANO) guidelines for palliative care in adults with malignant brain tumors. It provides an overview of palliative care options, including during the end-of-life phase for patients with malignant brain tumors.

methodsA systematic literature search was conducted from 2016 to 2021 focusing on four main topics: (1) symptom management, (2) caregiver needs, (3) early palliative care, and (4) care in the end-of-life phase. An international panel of palliative care experts in neuro-oncology synthesized the literature and reported the most relevant updates. A total of 140 articles were included.

resultsNew insights include that: Hippocampal avoidance and stereotactic radiosurgery results in a lower risk of neurocognitive decline in patients with brain metastases; levetiracetam is more efficacious in reducing seizures than valproic acid as first-line monotherapy antiseizure drug (ASD) in glioma patients; lacosamide and perampanel seem well-tolerated and efficacious add-on ASDs; and a comprehensive framework of palliative and supportive care for high-grade glioma patients and their caregivers was proposed. No pharmacological agents have been shown in randomized controlled trials to significantly improve fatigue or neurocognition.

conclusionsSince the 2017 EANO palliative care guidelines, new insights have been reported regarding symptom management and end-of-life care, however, most recommendations remain unchanged. Early palliative care interventions are essential to define goals of care and minimize symptom burden in a timely fashion. Interventional studies that address pain, fatigue, and psychiatric symptoms as well as (the timing of) early palliative care are urgently needed.

Indexed as

Brain NeoplasmsGliomaTerminal CareAdultDeathFatigueHumansbrain metastasesbrain tumorend of lifegliomapalliative care

Identifiers

PMID36271873
PMCPMC10013651
OpenAlexW4307090150

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.