Evidence map›Paper›PMID 39151765›Full record

ArticleJournal of pain and symptom management2024

Utilization of Palliative Radiation in Pediatric Oncology Patients During the End-of-Life (EOL).

Andrea Cuviello, Angélica F Figueroa Guzmán, Emily Zeng, Suraj Sarvode Mothi, Justin N Baker, Matthew J Krasin

Abstract read
In one paragraph

Article in Journal of pain and symptom management, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Andrea CuvielloPhoenix Children's (A.C.), Phoenix, Arizona, USA. Electronic address: ajcuviello@gmail.com.
Angélica F Figueroa GuzmánSchool of Medicine (A.F.G.), University of Puerto Rico, San Juan, Puerto Rico, USA.
Emily ZengSt. Jude Children's Research Hospital (E.Z., S.S.M.), Memphis, Tennessee, USA.
Suraj Sarvode MothiSt. Jude Children's Research Hospital (E.Z., S.S.M.), Memphis, Tennessee, USA.
Justin N BakerDivision of Quality of Life and Pediatric Palliative Care, Department of Pediatrics (J.N.B.), Stanford Medicine Children's Health, Palo Alto, California, USA.
Matthew J KrasinSt. Jude Children's Research Hospital (E.Z., S.S.M.), Memphis, Tennessee, USA.

Funding

Viral Vector Technology (VVTSR)P30CA021765 · NCI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI CHARLES ROBERTS · 1985 to 2026
$166.9M
PROFESSIONAL ONCOLOGY EDUCATION PROGRAMR25CA023944 · NCI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI SUZANNE A. GRONEMEYER · 1986 to 2026
$8.3M
NCI NIH HHS P30 CA021765NCI NIH HHS R25 CA023944
6 · The paper itself

Abstract

backgroundSuffering at the end-of-life (EOL) can impact the perception of a "good death" and ultimately affect bereavement for families of children with cancer. Palliative radiation (pXRT) is a tool that can address pain, mitigate suffering and improve quality of life.

methodsA retrospective medical record review of pediatric oncology patients who died over an 11-year period was completed. Descriptive analysis and nonparametric tests to compare groups were used.

results2202 total deaths occurred during the study period; 167 patients met study criteria, reflecting a 7.6% incidence of pXRT use at the EOL. Most patients were white (68%) and male (59%), with a median age of 9 years. Solid tumors were most common (52%), followed by CNS tumors (38%), and leukemia (10%). pXRT was primarily used to treat pain (37%) and focused on sites including brain/spine (37%), head/neck (24%), and pelvis (12%). Mean radiation dose delivered was 23.8Gy (range: 1.8-55.8 Gy) in a median of 7 fractions (range: 1-31). Side effects were rare and 58% of patients had a decrease in reported pain scores. Additionally, 87% received a pediatric palliative care (PPC) consultation which increased the likelihood for hospice referral, documented DNR preferences and decrease episodes of CPR on the day of death.

conclusionsThere is underutilization and significant variability in the use of pXRT during EOL in pediatric oncology. Barriers to this tool may include physician perceptions, family/patient preferences, and logistical hardships. Guidelines to standardize pXRT, alongside earlier PPC integration, may guide clinician decision making and increase pXRT utilization.

Indexed as

NeoplasmsPalliative CareTerminal CareAdolescentChildChild, PreschoolFemaleHumansInfantMaleRetrospective Studiesend-of-lifePalliative carepalliative radiationpediatric oncologysymptom management

Identifiers

PMID39151765
PMCPMC11534509

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Registered trials

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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.