Palliative Care and End-of-Life Issues in Patients with Brain Cancer Admitted to ICU
Sara Frisella,
Lapo Bonosi,
Mariachiara Ippolito,
Giuseppe Roberto Giammalva,
Gianluca Ferini,
Anna Viola,
Valentina Anna Marchese,
Giuseppe Emmanuele Umana,
Domenico Gerardo Iacopino,
Antonino Giarratano,
Andrea Cortegiani,
Rosario Maugeri
Affiliations
Sara Frisella
Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, 90100 Palermo, Italy
Lapo Bonosi
Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics (BiND), School of Medicine, University of Palermo, 90127 Palermo, Italy
Mariachiara Ippolito
Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, 90100 Palermo, Italy
Giuseppe Roberto Giammalva
Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics (BiND), School of Medicine, University of Palermo, 90127 Palermo, Italy
Gianluca Ferini
Department of Radiation Oncology, REM Radioterapia SRL, 95125 Catania, Italy
Anna Viola
Department of Radiation Oncology, REM Radioterapia SRL, 95125 Catania, Italy
Valentina Anna Marchese
Department of Radiation Oncology, REM Radioterapia SRL, 95125 Catania, Italy
Giuseppe Emmanuele Umana
Gamma Knife Center, Trauma Center, Department of Neurosurgery, Cannizzaro Hospital, 95100 Catania, Italy
Domenico Gerardo Iacopino
Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics (BiND), School of Medicine, University of Palermo, 90127 Palermo, Italy
Antonino Giarratano
Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, 90100 Palermo, Italy
Andrea Cortegiani
Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, 90100 Palermo, Italy
Rosario Maugeri
Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics (BiND), School of Medicine, University of Palermo, 90127 Palermo, Italy
Background and Objectives: Palliative care is an interdisciplinary medical specialty focused on improving the quality of life of critically ill patients, including those with frailty, during their illness. Materials and Methods: We conducted an extensive literature review on Pubmed focusing on palliative care in neuro-oncology patients admitted to intensive care units (ICUs). Results: We identified 967 articles and, after excluding 952 articles in accordance with the PRISMA flow chart, we included a total of 15 articles in the final selection. The potential role of palliative care in neuro-oncology appears necessary to ensure comprehensive end-of-life patient care. However, this seems underestimated and poorly applied, especially in the context of intensive care units. Medical personnel also face ethical dilemmas, considering not only the pathology but also the socio-spiritual context of the patient. In addition, caregivers’ understanding of prognosis and realistic goals is critical for optimal end-of-life management. Conclusions: The provision of palliative care to neuro-oncological patients admitted to ICU is a complex challenge supported by fragmented evidence. Additional research on palliative care and communication about end-of-life care in the neuro-oncology and neuro-ICU setting is needed.
