Abstract
INTRODUCTION: The effectiveness of palliative care for cancer patients has already been widely recognized. However, in Japan, palliative care for brain tumor patients remains in its early stages, and related information is limited. This is because the treatment culture for brain tumors in Japan is unique, with primary brain tumors being treated by neurosurgeons and metastatic brain tumors being treated by the department of the primary tumor, making it difficult to collect comprehensive information on end-of-life care for patients with malignant brain tumors. This study investigated end-of-life care for patients with malignant brain tumors from the perspective of a palliative care unit at a single hospital in Japan. PATIENTS AND METHODS: This study included 606 cancer patients who were admitted to the palliative care unit at Tsurumaki Onsen Hospital between January 2020 and December 2024 and received end-of-life care. Information was extracted from medical records and imaging tests, and a retrospective analysis was conducted. RESULTS: Of the 606 patients, 71 (11.7%) had malignant brain tumors (primary malignant brain tumors and metastatic brain tumors), of which 16 (2.6%) were primary and 55 (9.1%) were metastatic. Among the 71 cases,21 patients (29.6%) presented with impaired consciousness, and 29 patients (40.8%) were unable to take oral intake. Additionally, 15 patients (2.4%) experienced seizures during hospitalization, and 12 of these were patients with malignant brain tumors. DISCUSSION: The incidence of metastatic brain tumors was consistent with previous reports; however, based on the incidence rate, primary brain tumors are also frequently treated. Palliative care for common symptoms such as impaired consciousness and seizures in brain tumor patients is considered an important challenge for all of physicians treat brain tumors. CONCLUSION: A Japanese palliative care unit treats more brain tumor patients than anticipated. Smoothening collaboration between neurosurgeons and palliative physicians is essential for optimizing end-of-life care.