Integration of Pediatric Palliative Care in Children with Cancer: A Systematic Review

Abstract

In Colombia, cancer is the second cause of mortality in children. The city of Santiago de Cali has one of the biggest Cancer Infant Units in the country, but currently the integration of Pediatric Palliative Care (PPC) is done at the end of life. It is necessary to carry out a systematic review that supports the creation of a program of PPC that is integrated from the moment of the diagnosis of cancer. To compare an early vs late integration of the Palliative care team in children with cancer, establish the viability of the program and describe the acceptance from the patients, family and oncologist when PPC is introduced at the same time as curative treatment. Systematic review. PRISMA methodology. Four databases were searched. English and Spanish articles published between 2007 and 2017 were included. The search terms include key words and terms MeSH: intervention, palliative care, cancer, pediatric oncology. Descriptive statistics and narrative synthesis are used to summarize the findings. 252 studies were identified. Filters were used as: Access to the complete text, repeat articles, publication between 2007 and 2017, Spanish and English language. 25 articles were revised in total, of different methodologies like controlled clinical trials, descriptive, and systematic reviews. 20 articles were included for discussion. The viability of establishing CP programs that intervene early in patients diagnosed with cancer is confirmed. This model of attention integrated into the curative treatment, represents a positive impact in the control of symptoms, improvement of the quality of life, improvement of attention at the end of life, decrease of invasive end-of-life interventions, among others.