High-grade glioma (HGG) is characterized by debilitating neurologic symptoms and poor prognosis. Some of the suffering this disease engenders may be ameliorated through palliative care, which improves quality of life for seriously ill patients by optimizing symptom management and psychosocial support, which can be delivered concurrently with cancer-directed treatments. In this article, we review palliative care needs associated with HGG and identify opportunities for primary and specialty palliative care interventions. Patients with HGG and their caregivers experience high levels of distress due to physical, emotional, and cognitive symptoms that negatively impact quality of life and functional independence, all in the context of limited life expectancy. However, patients typically have limited contact with specialty palliative care until the end of life, and there is no established model for ensuring their palliative care needs are met throughout the disease course. We identify low rates of advance care planning, misconceptions about palliative care being synonymous with end-of-life care, and the unique neurologic needs of this patient population as some of the potential barriers to increased palliative interventions. Further research is needed to define the optimal roles of neuro-oncologists and palliative care specialists in the management of this illness and to establish appropriate timing and models for palliative care delivery.

中文翻译：

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高级别胶质瘤的姑息治疗：综述

高级别胶质瘤 (HGG) 的特点是神经系统症状衰弱和预后不良。这种疾病引起的一些痛苦可以通过姑息治疗得到改善，姑息治疗通过优化症状管理和社会心理支持来改善重病患者的生活质量，这可以与针对癌症的治疗同时进行。在这篇文章中，我们回顾了与 HGG 相关的姑息治疗需求，并确定了初级和专业姑息治疗干预的机会。HGG 患者及其护理人员因身体、情绪和认知症状而感到高度痛苦，这些症状对生活质量和功能独立性产生负面影响，所有这些都是在预期寿命有限的情况下发生的。然而，患者通常在生命结束之前与专业姑息治疗的接触有限，并且没有确定的模型来确保他们的姑息治疗需求在整个疾病过程中得到满足。我们发现预先护理计划率低、将姑息治疗等同于临终关怀的误解以及该患者群体独特的神经系统需求是增加姑息干预的一些潜在障碍。需要进一步的研究来确定神经肿瘤学家和姑息治疗专家在这种疾病管理中的最佳作用，并为姑息治疗的实施建立适当的时机和模式。关于姑息治疗等同于临终关怀的误解，以及这一患者群体独特的神经系统需求是增加姑息治疗的一些潜在障碍。需要进一步的研究来确定神经肿瘤学家和姑息治疗专家在这种疾病管理中的最佳作用，并为姑息治疗的实施建立适当的时机和模式。关于姑息治疗等同于临终关怀的误解，以及这一患者群体独特的神经系统需求是增加姑息治疗的一些潜在障碍。需要进一步的研究来确定神经肿瘤学家和姑息治疗专家在这种疾病管理中的最佳作用，并为姑息治疗的实施建立适当的时机和模式。