The Last 10 Days of Patients With Glioblastoma: Assessment of Clinical Signs and Symptoms as well as Treatment.
BACKGROUND
High-grade gliomas are the most frequent primary brain tumors. Despite improvement in diagnostics and treatment, survival is still poor and quality-of-life issues are of major importance. Little is known regarding the clinical signs and symptoms of dying patients with glioblastoma.


OBJECTIVE
The aim of this study was to investigate signs and symptoms as well as therapeutic strategies in patients with glioblastoma in the end-of-life phase in order to improve end-of-life care.


METHODS
In this prospective single-center study, clinical data were obtained using a standardized protocol. We descriptively analyzed signs, symptoms, and therapeutic strategies on a daily basis.


RESULTS
A total of 57 patients, who died due to glioblastoma in a hospital setting, were included. The most frequent signs and symptoms in the last 10 days before death were decrease in level of consciousness (95%), fever (88%), dysphagia (65%), seizures (65%), and headache (33%). Concerning medication, 95% received opioids. There was a high need for nonsteroidal anti-inflammatory drugs (77%) and anticonvulsants (75%). Steroids were given to 56%.


CONCLUSION
Due to a decrease in level of consciousness and cognitive impairment, assessment of clinical signs and symptoms such as headache at the end of life is difficult. Based on the signs and symptoms in the last days before death in patients with glioblastoma, supportive drug treatment remains challenging. Our study emphasizes the importance of standardized guidelines for end-of-life care in patients with glioblastoma.
['Thier|Katrin|K|', 'Calabek|Bernadette|B|', 'Tinchon|Alexander|A|', 'Grisold|Wolfgang|W|', 'Oberndorfer|Stefan|S|']
D000305:Adrenal Cortex Hormones D000368:Aged D000701:Analgesics, Opioid D000894:Anti-Inflammatory Agents, Non-Steroidal D000927:Anticonvulsants D001932:Brain Neoplasms D003680:Deglutition Disorders D005260:Female D005334:Fever D005440:Fluid Therapy D005909:Glioblastoma D006801:Humans D008297:Male D008875:Middle Aged D010166:Palliative Care D011446:Prospective Studies D011788:Quality of Life D012640:Seizures D013727:Terminal Care D014474:Unconsciousness D055986:Vital Signs
glioblastoma end of life palliative care supportive care