Raising Awareness: Real World Data On Palliative Care for Advanced Pediatric Cancers in Bavaria

Nehls, Nadja and Boerner, Maja and Ziegelmayer, Sebastian and Haller, Bernhard and Ferrari-von Klot, Felicitas and Metzler, Markus and Fruehwald, Michael C. and Schlegel, Paul-Gerhardt and Corbacioglu, Selim and Feuchtinger, Tobias and Teichert-von Luettichau, Irene (2025) Raising Awareness: Real World Data On Palliative Care for Advanced Pediatric Cancers in Bavaria. PEDIATRIC BLOOD & CANCER, 72 (9). ISSN 1545-5009, 1545-5017

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Abstract

IntroductionEarly integration of palliative care in children with cancer provides a variety of positive effects and is recommended at diagnosis. However, barriers often delay its implementation, and palliative care remains underutilized. This study provides real-world data on palliative care and integration in pediatric oncology in a high-income country.MethodsIn this retrospective observational study, data derived from patients with refractory, progressive, or relapsed malignancies under the age of 18 years were collected from six German pediatric oncology centers (2017-2022). In addition to palliative data (onset, and duration of palliative care services, frequency of contact, place of death), disease entity, relapse/progression frequency, Karnofsky Performance Scale Index, therapy, and overall survival were collected. The frequency, timepoint of initiation and the duration of palliative care services were examined in relation to the disease trajectory (diagnosis to death/censoring) and tumor entity. Outcomes (overall survival, Karnofsky Performance Scale Index, place of death) were analyzed based on palliative care status.ResultsOnly 157 (42%) of the 373 patients received palliative care services. The mean duration of palliative involvement was 6.0 months with a mean disease trajectory of 31.4 months for patients receiving palliative care. On average, palliative care was initiated in the last third of the disease trajectory. Most of the 157 patients (65.9%) received palliative care during their final relapse/progression and only 16.8% at diagnosis. There was a significantly lower frequency of palliative care involvement for children with hematological malignancies.ConclusionDespite the substantial benefits, this study highlights significant delays and underutilization of palliative care for pediatric oncology patients, even in a high-income country.

Item Type: Article
Uncontrolled Keywords: OF-LIFE CARE; CHILDREN; END; COUNTRIES; BARRIERS; EUROPE; HEALTH; pediatric oncology; palliative care; cancer; high-income country; underutilization palliative care; real-world data
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Abteilung für Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation
Depositing User: Dr. Gernot Deinzer
Date Deposited: 01 Apr 2026 09:14
Last Modified: 01 Apr 2026 09:14
URI: https://pred.uni-regensburg.de/id/eprint/67751

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