Palliative care for patients with primary and metastatic brain tumors

Patients with malignant brain tumors and brain metastases suffer from severe symptoms throughout the course of their disease, which requires special attention and comprehensive care to maintain their quality of life. This article provides a literature review, with an emphasis on the practical aspects of controlling the most common and disabling symptoms. Four main topics are discussed: symptom control, caregiver`s needs, palliative care during active cancer treatment, and end of life care. New data on the prevention of neurocognitive deficits through improved radiotherapy techniques and the choice of anticonvulsants for patients with seizure syndrome are presented. The main therapeutic options for managing weakness, neurocognitive decline, headache, and other types of pain are described, along with the current limitations of these treatments. The strategy for using opioids in this patient group is also discussed. The development and implementation of advance care planning programs can help ensure that care is aligned with the needs of patients and caregivers, which may reduce the volume of inpatient care and avoid unnecessary aggressive treatment at the end of life. The integration of palliative care into the healthcare system for patients with brain tumors is a paramount. There is a need to establish specialized palliative care services for this patient group and to provide targeted training for specialists. It is necessary to develop practical supportive and palliative care guidelines for patients with brain tumors, including end of life care.

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