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Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable...

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Page 1: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 2: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Pognostication in pediatric oncology palliative care

MvandeWetering,pediatriconcologist

Page 3: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

ChildhoodcancerReaches80%survivaloverall

Page 4: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 5: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

16yearoldboyGlioblastomaMul3formeWHOIVTreatmentRT+temozolamideandmaintenanceTemozolamidex6months9monthaCerdiagnosisheprogressedReirradia3onnoeffect,Deteriora3onclinicalcondi3on-Pallia3vephaseHowtoPrognos3cate

Page 6: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 7: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 8: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Aug2017primarydiagnosisIniAaltreatmentRTandTemozolamideApril2018relapseRT?TrialinvolvementPalliaAvecare

Page 9: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 10: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Allabovesymptomswerepresentinourpa3ent

Page 11: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 12: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

(NEnglJMed2000;342:326-33.)

Page 13: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 14: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 15: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 16: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 17: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 18: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 19: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Page 20: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

Conclusiononhowtoofferbestpallia3vecareforLLC

•  AdequatecommunicaAveskills•  Guidelinesastooltoeducatecaregivers•  PredicAonofsymptomsbasedonresearch•  AndapalliaAvecareteamtosupportchildparentsandsiblings.

Page 21: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

And our patient???? He chose to stay in the hospital and spend his last days with his family around him He was prepared as to what was going to happen and was not anxious…………….

Page 22: Pognostication in pediatric oncology palliative care · Days from inYal dicgnos's to incurable diseased Median Range Reason for start pall'ct.ve phcsec Incurable from diagnos's, n

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