Patients with high-grade glioma (HGG) may not receive timely palliative care consultations, according to research presented in a poster at the Society for Neuro-Oncology 27th Annual Meeting.
In a cohort of more than 600 patients with HGG, about 1 in 10 patients had a palliative care consultation before the end-of-life phase.
This study included 621 patients enrolled in the Mount Sinai Health System cancer registry. They had glioblastoma (83.7%), anaplastic astrocytoma (11%), or anaplastic oligodendroglioma (5.3%). The mean age was 59.4 years at HGG diagnosis, 44.9% of patients were women, and 64.1% were White. Most patients (93.9%) had supratentorial tumors. Few (9.1%) died during hospitalization.
Most patients (78.42%) did not receive a palliative care consultation. The patients who did receive a consultation had higher Charlson Comorbidity Index scores (mean, 4.7 vs 2.2; P <.01), were more likely to have glioblastoma (89.6% vs 82.1%; P =.04), and were more likely to die in hospital (22.0% vs 3.1%) or be discharged to hospice (33.1% vs 22.3%; P <.01).
Among patients who had one, the initial palliative care consultation occurred prior to receiving radiation or chemotherapy for 14 patients, during first-line treatment for 35 patients, during second-line or greater treatment for 20 patients, and during the end-of-life phase for 65 patients.
Most consultations (83%) occurred in the inpatient setting only, 13% occurred in the outpatient setting only, and 3.7% occurred in both settings.
The median time to death was 12 months among patients who received a consultation and 14 months among those who did not (P =.34).
The median time to death was longer for patients who had a consultation before the end-of-life phase than for those who had a consultation during the end-of-life phase —16.5 months and 11 months, respectively (P =.0092).
“Only about one in 10 patients in the entire cohort potentially received the benefits of palliative care consultation prior to the end-of-life phase, indicating likely gaps in palliative care delivery for this population,” the researchers wrote. “[F]urther research on barriers and facilitators of timely palliative care consultation is needed.”
Disclosures: The study authors did not provide disclosures.
Crooms RC, Taylor J, Jette N, et al. Palliative care referral across the disease trajectory in high-grade glioma. Presented at SNO 2022; November 16-20, 2022. Abstract EOLP-01.