Os07.6.a Specialized Palliative Care Interventions and Survival in Patients With Glioblastoma - A Retrospective, Monocentric Study

Abstract BACKGROUND Patients with glioblastoma not only suffer from a life-threatening oncological disease, but also present with severe neurological symptoms, e.g. seizures or hemiparesis, and a high degree of psychosocial distress. Frequently, the need for specialized palliative care (SPC) increases during the course of the disease but is often inadequately assessed and treated MATERIAL AND METHODS In this monocentric, retrospective study, we analyzed data from patients diagnosed with glioblastoma between 2014 and 2024 in a large brain tumor center, provided by the regional tumor center and completed with data from electronic patient records, general practitioners and SPC teams for the outpatient sector. Interrelations with sociodemographic, clinical, and treatment aspects were investigated using the Pearson’s Chi-square test and an univariable and multivariable binary logistic regression analysis. The survival time was evaluated using the Kaplan-Meier method. A multivariable Cox proportional-hazards model was applied to estimate the impact of SPC on survival. RESULTS A cohort of 274 patients with glioblastoma was investigated, of whom 210 (76.6%) received SPC. Patients who had at least one SPC consultation (p 0.001; OR: 0.302; 95% CI: 0.157-0.584) and patients with methylation of the MGMT promoter region (p = 0.005; OR: 0.375; 95% CI: 0.190-0.739) were less likely to receive a tumor-specific therapy in the last 30 days prior to death. Median overall survival was 16.9 months (95% CI: 14.5-19.3 months) for patients with at least one SPC consultation (n = 210) vs. 12.9 months (95% CI: 10.8-15.1 months) for patients without (n = 64). The Cox proportional hazards model demonstrated that SPC was associated with longer overall survival (p = 0.017; HR: 0.707; 95% CI: 0.532-0.939). CONCLUSION This monocentric study revealed a broad availability of SPC interventions for patients with glioblastoma. Patients who received SPC had a statistically significant benefit in view of clinical aspects. We conclude that utmost efforts should be made to incorporate SPC into the care of every patient with glioblastoma within a standardized framework. This study further highlights the importance of future research on a cross-sectional approach to identify SPC needs as well as the kind and frequency of interventions in this highly burdened patient group.