Skip to main content
SpringerLink
Log in

Malignant Brain Tumors

  • Chapter
  • First Online:
Neuropalliative Care

Abstract

The brain tumor patient presents as a complex challenge to the care provider, demanding a knowledge of their cancer, its treatment and complications, and the neurological impact of the tumor. Brain tumors may range from primary to metastatic, from surgically curable to highly malignant. Each type of tumor has its own unique impact, and the management, prognosis and long-term outcomes differ for each patient. It is outside the scope of this chapter to review all of these trajectories individually. Instead, we aim to make certain generalizations on the presentation, management and course of primary and metastatic brain tumors as a group. We present some of the most common symptoms experienced by this patient group and make suggestions on management. We also focus on the important subject of advanced care and end of life planning in this population, as well as discuss how the clinician can help prepare the patient and caregivers for the end of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE. Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol. 2004;22(14):2865–72.

    PubMed  Google Scholar 

  2. Maher EA, McKee AC. Neoplasms of the central nervous system. In: Skarin AT, Canellos GP, editors. Atlas of diagnostic oncology. 3rd ed. London: Elsevier Science Ltd.; 2003.

    Google Scholar 

  3. Ostrom QT, Gittleman H, Xu J, Kromer C, Wolinsky Y, Kruchko C, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2009–2013. Neuro-Oncology. 2016;18(Suppl_5):v1–75.

    PubMed  Google Scholar 

  4. Porter KR, McCarthy BJ, Freels S, Kim Y, Davis FG. Prevalence estimates for primary brain tumors in the United States by age, gender, behavior, and histology. Neuro-Oncology. 2010;12(6):520–7.

    PubMed  PubMed Central  Google Scholar 

  5. Frankel S, German W. Glioblastoma multiforme; review of 219 cases with regard to natural history, pathology, diagnostic methods, and treatment. J Neurosurg. 1958;15(5):489–503.

    CAS  PubMed  Google Scholar 

  6. Roth JG, Elvidge AR. Glioblastoma multiforme: a clinical survey. J Neurosurg. 1960;17:736–50.

    CAS  PubMed  Google Scholar 

  7. Nelson S, Taylor LP. Headaches in brain tumor patients: primary or secondary? Headache. 2014;54(4):776–85.

    PubMed  Google Scholar 

  8. Taylor LP. Mechanism of brain tumor headache. Headache. 2014;54(4):772–5.

    PubMed  Google Scholar 

  9. Chandana SR, Movva S, Arora M, Singh T. Primary brain tumors in adults. Am Fam Physician. 2008;77(10):1423–30.

    PubMed  Google Scholar 

  10. Jacobs AH, Kracht LW, Gossmann A, Rüger MA, Thomas AV, Thiel A, et al. Imaging in neurooncology. NeuroRx. 2005;2(2):333–47.

    PubMed  PubMed Central  Google Scholar 

  11. Trifiletti DM, Alonso C, Grover S, Fadul CE, Sheehan JP, Showalter TN. Prognostic implications of extent of resection in glioblastoma: analysis from a large database. World Neurosurg. 2017;103:330–40.

    PubMed  Google Scholar 

  12. Mehta MP, Rodrigus P, Terhaard CH, Rao A, Suh J, Roa W, et al. Survival and neurologic outcomes in a randomized trial of motexafin gadolinium and whole-brain radiation therapy in brain metastases. J Clin Oncol. 2003;21(13):2529–36.

    CAS  PubMed  Google Scholar 

  13. Mehta MP, Ahluwalia MS. Whole-brain radiotherapy and stereotactic radiosurgery in brain metastases: what is the evidence? Am Soc Clin Oncol Educ Book. 2015:e99–104. doi:10.14694/EdBook_AM.2015.35.e99.

    Google Scholar 

  14. Brown PD, Pugh S, Laack NN, Wefel JS, Khuntia D, Meyers C, et al. Memantine for the prevention of cognitive dysfunction in patients receiving whole-brain radiotherapy: a randomized, double-blind, placebo-controlled trial. Neuro-Oncology. 2013;15(10):1429–37.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352(10):987–96.

    CAS  Google Scholar 

  16. Cloughesy TF, Prados MD, Wen PY, Mikkelsen T, Abrey LE, Schiff D, et al. A phase II, randomized, non-comparative clinical trial of the effect of bevacizumab (BV) alone or in combination with irinotecan (CPT) on 6-month progression free survival (PFS6) in recurrent, treatment-refractory glioblastoma (GBM). J Clin Oncol. 2008;26(15_suppl):2010b-b.

    Google Scholar 

  17. Gilbert MR, Dignam JJ, Armstrong TS, Wefel JS, Blumenthal DT, Vogelbaum MA, et al. A randomized trial of bevacizumab for newly diagnosed glioblastoma. N Engl J Med. 2014;370(8):699–708.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Norden AD, Bartolomeo J, Tanaka S, Drappatz J, Ciampa AS, Doherty LM, et al. Safety of concurrent bevacizumab therapy and anticoagulation in glioma patients. J Neuro-Oncol. 2012;106(1):121–5.

    CAS  Google Scholar 

  19. Fraum TJ, Kreisl TN, Sul J, Fine HA, Iwamoto FM. Ischemic stroke and intracranial hemorrhage in glioma patients on antiangiogenic therapy. J Neuro-Oncol. 2011;105(2):281–9.

    CAS  Google Scholar 

  20. Sharma K, Marcus JR. Bevacizumab and wound-healing complications: mechanisms of action, clinical evidence, and management recommendations for the plastic surgeon. Ann Plast Surg. 2013;71(4):434–40.

    CAS  PubMed  Google Scholar 

  21. Tlemsani C, Mir O, Boudou-Rouquette P, Huillard O, Maley K, Ropert S, et al. Posterior reversible encephalopathy syndrome induced by anti-VEGF agents. Target Oncol. 2011;6(4):253–8.

    PubMed  Google Scholar 

  22. Schouten LJ, Rutten J, Huveneers HA, Twijnstra A. Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer. 2002;94(10):2698–705.

    PubMed  Google Scholar 

  23. Clarke JL, Perez HR, Jacks LM, Panageas KS, Deangelis LM. Leptomeningeal metastases in the MRI era. Neurology. 2010;74(18):1449–54.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Waki F, Ando M, Takashima A, Yonemori K, Nokihara H, Miyake M, et al. Prognostic factors and clinical outcomes in patients with leptomeningeal metastasis from solid tumors. J Neuro-Oncol. 2009;93(2):205–12.

    Google Scholar 

  25. Wasserstrom WR, Glass JP, Posner JB. Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients. Cancer. 1982;49(4):759–72.

    CAS  PubMed  Google Scholar 

  26. Grossman SA, Moynihan TJ. Neoplastic meningitis. Neurol Clin. 1991;9(4):843–56.

    CAS  PubMed  Google Scholar 

  27. Freilich RJ, Krol G, DeAngelis LM. Neuroimaging and cerebrospinal fluid cytology in the diagnosis of leptomeningeal metastasis. Ann Neurol. 1995;38(1):51–7.

    CAS  PubMed  Google Scholar 

  28. Collie DA, Brush JP, Lammie GA, Grant R, Kunkler I, Leonard R, et al. Imaging features of leptomeningeal metastases. Clin Radiol. 1999;54(11):765–71.

    CAS  PubMed  Google Scholar 

  29. Minniti G, Paolini S, D’Andrea G, Lanzetta G, Cicone F, Confaloni V, et al. Outcomes of postoperative stereotactic radiosurgery to the resection cavity versus stereotactic radiosurgery alone for melanoma brain metastases. J Neuro-Oncol. 2017;132(3):455–62.

    PubMed  Google Scholar 

  30. Minniti G, Esposito V, Clarke E, Scaringi C, Lanzetta G, Salvati M, et al. Multidose stereotactic radiosurgery (9 Gy × 3) of the postoperative resection cavity for treatment of large brain metastases. Int J Radiat Oncol Biol Phys. 2013;86(4):623–9.

    PubMed  Google Scholar 

  31. Brennan C, Yang TJ, Hilden P, Zhang Z, Chan K, Yamada Y, et al. A phase 2 trial of stereotactic radiosurgery boost after surgical resection for brain metastases. Int J Radiat Oncol Biol Phys. 2014;88(1):130–6.

    PubMed  PubMed Central  Google Scholar 

  32. Patchell RA, Regine WF, Loeffler JS, Sawaya R, Andrews DW, Chin LS. Radiosurgery plus whole-brain radiation therapy for brain metastases. JAMA. 2006;296(17):2089–90; author reply 2090–1.

    CAS  PubMed  Google Scholar 

  33. Vecht CJ. Clinical management of brain metastasis. J Neurol. 1998;245(3):127–31.

    CAS  PubMed  Google Scholar 

  34. Brown PD, Ballman KV, Cerhan JH, Anderson SK, Carrero XW, Whitton AC, et al. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC·3): a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18:1049.

    PubMed  PubMed Central  Google Scholar 

  35. Houillier C, Wang X, Kaloshi G, Mokhtari K, Guillevin R, Laffaire J, et al. IDH1 or IDH2 mutations predict longer survival and response to temozolomide in low-grade gliomas. Neurology. 2010;75(17):1560–6.

    CAS  PubMed  Google Scholar 

  36. Borgelt B, Gelber R, Kramer S, Brady LW, Chang CH, Davis LW, et al. The palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys. 1980;6(1):1–9.

    CAS  PubMed  Google Scholar 

  37. DeAngelis LM, Boutros D. Leptomeningeal metastasis. Cancer Investig. 2005;23(2):145–54.

    Google Scholar 

  38. Halkett GK, Lobb EA, Oldham L, Nowak AK. The information and support needs of patients diagnosed with High Grade Glioma. Patient Educ Couns. 2010;79(1):112–9.

    PubMed  Google Scholar 

  39. Gould SJ. The median isn’t the message. Virtual Mentor. 2013;15(1):77–81.

    PubMed  Google Scholar 

  40. Fritz L, Dirven L, Reijneveld JC, Koekkoek JA, Stiggelbout AM, Pasman HR, et al. Advance care planning in glioblastoma patients. Cancers (Basel). 2016;8(11):102.

    Google Scholar 

  41. Von Roenn JH, von Gunten CF. Setting goals to maintain hope. J Clin Oncol. 2003;21(3):570–4.

    Google Scholar 

  42. Taillibert S, Laigle-Donadey F, Sanson M. Palliative care in patients with primary brain tumors. Curr Opin Oncol. 2004;16(6):587–92.

    PubMed  Google Scholar 

  43. Daly FN, Schiff D. Supportive management of patients with brain tumors. Expert Rev Neurother. 2007;7(10):1327–36.

    CAS  PubMed  Google Scholar 

  44. Pace A, Di Lorenzo C, Lorenzo CD, Guariglia L, Jandolo B, Carapella CM, et al. End of life issues in brain tumor patients. J Neuro-Oncol. 2009;91(1):39–43.

    Google Scholar 

  45. Thier K, Calabek B, Tinchon A, Grisold W, Oberndorfer S. The last 10 days of patients with glioblastoma: assessment of clinical signs and symptoms as well as treatment. Am J Hosp Palliat Care. 2015;33(10):985–8.

    Google Scholar 

  46. Sizoo EM, Pasman HR, Buttolo J, Heimans JJ, Klein M, Deliens L, et al. Decision-making in the end-of-life phase of high-grade glioma patients. Eur J Cancer. 2012;48(2):226–32.

    PubMed  Google Scholar 

  47. Diamond EL, Russell D, Kryza-Lacombe M, Bowles KH, Applebaum AJ, Dennis J, et al. Rates and risks for late referral to hospice in patients with primary malignant brain tumors. Neuro-Oncology. 2016;18(1):78–86.

    PubMed  Google Scholar 

  48. Teno JM, Gruneir A, Schwartz Z, Nanda A, Wetle T. Association between advance directives and quality of end-of-life care: a national study. J Am Geriatr Soc. 2007;55(2):189–94.

    PubMed  Google Scholar 

  49. Song K. Advance care planning in patients with brain tumours: a prospective cohort study. J Cancer Res Ther. 2015;7(3):85–91.

    Google Scholar 

  50. Song K, Amatya B, Voutier C, Khan F. Advance care planning in patients with primary malignant brain tumors: a systematic review. Front Oncol. 2016;6:223.

    PubMed  PubMed Central  Google Scholar 

  51. Péus D, Newcomb N, Hofer S. Appraisal of the karnofsky performance status and proposal of a simple algorithmic system for its evaluation. BMC Med Inform Decis Mak. 2013;13:72.

    PubMed  PubMed Central  Google Scholar 

  52. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5(6):649–55.

    CAS  PubMed  Google Scholar 

  53. Bergo E, Lombardi G, Guglieri I, Capovilla E, Pambuku A, Zagonel V. Neurocognitive functions and health-related quality of life in glioblastoma patients: a concise review of the literature. Eur J Cancer Care (Engl). 2015; https://doi.org/10.1111/ecc.12410.

    PubMed  Google Scholar 

  54. Gehrke AK, Baisley MC, Sonck AL, Wronski SL, Feuerstein M. Neurocognitive deficits following primary brain tumor treatment: systematic review of a decade of comparative studies. J Neuro-Oncol. 2013;115(2):135–42.

    Google Scholar 

  55. Davidson PS, Gao FQ, Mason WP, Winocur G, Anderson ND. Verbal fluency, trail making, and Wisconsin Card Sorting Test performance following right frontal lobe tumor resection. J Clin Exp Neuropsychol. 2008;30(1):18–32.

    PubMed  Google Scholar 

  56. Rapp SR, Case LD, Peiffer A, Naughton MM, Chan MD, Stieber VW, et al. Donepezil for irradiated brain tumor survivors: a phase III randomized placebo-controlled clinical trial. J Clin Oncol. 2015;33(15):1653–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  57. Hulshof MC, Stark NM, van der Kleij A, Sminia P, Smeding HM, Gonzalez GD. Hyperbaric oxygen therapy for cognitive disorders after irradiation of the brain. Strahlenther Onkol. 2002;178(4):192–8.

    PubMed  Google Scholar 

  58. Zucchella C, Capone A, Codella V, De Nunzio AM, Vecchione C, Sandrini G, et al. Cognitive rehabilitation for early post-surgery inpatients affected by primary brain tumor: a randomized, controlled trial. J Neuro-Oncol. 2013;114(1):93–100.

    CAS  Google Scholar 

  59. Catt S, Chalmers A, Fallowfield L. Psychosocial and supportive-care needs in high-grade glioma. Lancet Oncol. 2008;9(9):884–91.

    PubMed  Google Scholar 

  60. Pelletier G, Verhoef MJ, Khatri N, Hagen N. Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. J Neuro-Oncol. 2002;57(1):41–9.

    Google Scholar 

  61. Hickmann AK, Nadji-Ohl M, Haug M, Hopf NJ, Ganslandt O, Giese A, et al. Suicidal ideation, depression, and health-related quality of life in patients with benign and malignant brain tumors: a prospective observational study in 83 patients. Acta Neurochir. 2016;158(9):1669–82.

    PubMed  Google Scholar 

  62. Litofsky NS, Farace E, Anderson F, Meyers CA, Huang W, Laws ER, et al. Depression in patients with high-grade glioma: results of the Glioma Outcomes Project. Neurosurgery. 2004;54(2):358–66; discussion 366–7.

    PubMed  Google Scholar 

  63. Rooney A, Grant R. Pharmacological treatment of depression in patients with a primary brain tumour. Cochrane Database Syst Rev. 2013;(5):CD006932.

    Google Scholar 

  64. Wen PY, Schiff D, Kesari S, Drappatz J, Gigas DC, Doherty L. Medical management of patients with brain tumors. J Neuro-Oncol. 2006;80(3):313–32.

    CAS  Google Scholar 

  65. Johannessen Landmark C, Henning O, Johannessen SI. Proconvulsant effects of antidepressants – What is the current evidence? Epilepsy Behav. 2016;61:287–91.

    PubMed  Google Scholar 

  66. Verrotti A, Prezioso G, Di Sabatino F, Franco V, Chiarelli F, Zaccara G. The adverse event profile of levetiracetam: a meta-analysis on children and adults. Seizure. 2015;31:49–55.

    PubMed  Google Scholar 

  67. Molassiotis A, Wilson B, Brunton L, Chaudhary H, Gattamaneni R, McBain C. Symptom experience in patients with primary brain tumours: a longitudinal exploratory study. Eur J Oncol Nurs. 2010;14(5):410–6.

    PubMed  Google Scholar 

  68. Faithfull S, Brada M. Somnolence syndrome in adults following cranial irradiation for primary brain tumours. Clin Oncol (R Coll Radiol). 1998;10(4):250–4.

    CAS  Google Scholar 

  69. Lovely MP, Miaskowski C, Dodd M. Relationship between fatigue and quality of life in patients with glioblastoma multiformae. Oncol Nurs Forum. 1999;26(5):921–5.

    CAS  PubMed  Google Scholar 

  70. Day J, Yust-Katz S, Cachia D, Wefel J, Katz LH, Tremont I, et al. Interventions for the management of fatigue in adults with a primary brain tumour. Cochrane Database Syst Rev. 2016;(4):CD011376.

    Google Scholar 

  71. Adelbratt S, Strang P. Death anxiety in brain tumour patients and their spouses. Palliat Med. 2000;14(6):499–507.

    CAS  PubMed  Google Scholar 

  72. Strang S, Strang P, Ternestedt BM. Existential support in brain tumour patients and their spouses. Support Care Cancer. 2001;9(8):625–33.

    CAS  PubMed  Google Scholar 

  73. van Breemen MS, Wilms EB, Vecht CJ. Epilepsy in patients with brain tumours: epidemiology, mechanisms, and management. Lancet Neurol. 2007;6(5):421–30.

    PubMed  Google Scholar 

  74. Glantz MJ, Cole BF, Forsyth PA, Recht LD, Wen PY, Chamberlain MC, et al. Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Report of the quality standards subcommittee of the American Academy of Neurology. Neurology. 2000;54(10):1886–93.

    CAS  PubMed  Google Scholar 

  75. Mikkelsen T, Paleologos NA, Robinson PD, Ammirati M, Andrews DW, Asher AL, et al. The role of prophylactic anticonvulsants in the management of brain metastases: a systematic review and evidence-based clinical practice guideline. J Neuro-Oncol. 2010;96(1):97–102.

    Google Scholar 

  76. Perucca E. Optimizing antiepileptic drug treatment in tumoral epilepsy. Epilepsia. 2013;54(Suppl 9):97–104.

    CAS  PubMed  Google Scholar 

  77. Delattre JY, Safai B, Posner JB. Erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and phenytoin. Neurology. 1988;38(2):194–8.

    CAS  PubMed  Google Scholar 

  78. Hoang-Xuan K, Delattre JY, Poisson M. Stevens-Johnson syndrome in a patient receiving cranial irradiation and carbamazepine. Neurology. 1990;40(7):1144–5.

    CAS  PubMed  Google Scholar 

  79. Lawson LA, Blouin RA, Smith RB, Rapp RP, Young AB. Phenytoin-dexamethasone interaction: a previously unreported observation. Surg Neurol. 1981;16(1):23–4.

    CAS  PubMed  Google Scholar 

  80. Schiff D, Lee EQ, Nayak L, Norden AD, Reardon DA, Wen PY. Medical management of brain tumors and the sequelae of treatment. Neuro-Oncology. 2015;17(4):488–504.

    CAS  PubMed  Google Scholar 

  81. Rossetti AO, Jeckelmann S, Novy J, Roth P, Weller M, Stupp R. Levetiracetam and pregabalin for antiepileptic monotherapy in patients with primary brain tumors. A phase II randomized study. Neuro-Oncology. 2014;16(4):584–8.

    CAS  PubMed  Google Scholar 

  82. Usery JB, Michael LM, Sills AK, Finch CK. A prospective evaluation and literature review of levetiracetam use in patients with brain tumors and seizures. J Neuro-Oncol. 2010;99(2):251–60.

    Google Scholar 

  83. Brodie MJ, Besag F, Ettinger AB, Mula M, Gobbi G, Comai S, et al. Epilepsy, antiepileptic drugs, and aggression: an evidence-based review. Pharmacol Rev. 2016;68(3):563–602.

    PubMed  PubMed Central  Google Scholar 

  84. Weller M, Gorlia T, Cairncross JG, van den Bent MJ, Mason W, Belanger K, et al. Prolonged survival with valproic acid use in the EORTC/NCIC temozolomide trial for glioblastoma. Neurology. 2011;77(12):1156–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  85. Kerkhof M, Dielemans JC, van Breemen MS, Zwinkels H, Walchenbach R, Taphoorn MJ, et al. Effect of valproic acid on seizure control and on survival in patients with glioblastoma multiforme. Neuro-Oncology. 2013;15(7):961–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  86. Kerkhof M, Vecht CJ. Seizure characteristics and prognostic factors of gliomas. Epilepsia. 2013;54(Suppl 9):12–7.

    PubMed  Google Scholar 

  87. Chaichana KL, Parker SL, Olivi A, Quiñones-Hinojosa A. Long-term seizure outcomes in adult patients undergoing primary resection of malignant brain astrocytomas. Clin Artic J Neurosurg. 2009;111(2):282–92.

    Google Scholar 

  88. Flechl B, Ackerl M, Sax C, Oberndorfer S, Calabek B, Sizoo E, et al. The caregivers’ perspective on the end-of-life phase of glioblastoma patients. J Neuro-Oncol. 2013;112(3):403–11.

    Google Scholar 

  89. Ly KI, Wen PY. Clinical relevance of steroid use in neuro-oncology. Curr Neurol Neurosci Rep. 2017;17(1):5.

    PubMed  Google Scholar 

  90. Hempen C, Weiss E, Hess CF. Dexamethasone treatment in patients with brain metastases and primary brain tumors: do the benefits outweigh the side-effects? Support Care Cancer. 2002;10(4):322–8.

    PubMed  Google Scholar 

  91. Liu R, Page M, Solheim K, Fox S, Chang SM. Quality of life in adults with brain tumors: current knowledge and future directions. Neuro-Oncology. 2009;11(3):330–9.

    PubMed  PubMed Central  Google Scholar 

  92. Russo M, Villani V, Taga A, Genovese A, Terrenato I, Manzoni GC, et al. Headache as a presenting symptom of glioma: a cross-sectional study. Cephalalgia. 2017;38(4):730–5.

    PubMed  Google Scholar 

  93. Walbert T, Khan M. End-of-life symptoms and care in patients with primary malignant brain tumors: a systematic literature review. J Neuro-Oncol. 2014;117(2):217–24.

    Google Scholar 

  94. Bausewein C, Hau P, Borasio GD, Voltz R. How do patients with primary brain tumours die? Palliat Med. 2003;17(6):558–9.

    CAS  PubMed  Google Scholar 

  95. Sherwood PR, Given BA, Doorenbos AZ, Given CW. Forgotten voices: lessons from bereaved caregivers of persons with a brain tumour. Int J Palliat Nurs. 2004;10(2):67–75; discussion.

    PubMed  Google Scholar 

  96. Janda M, Steginga S, Dunn J, Langbecker D, Walker D, Eakin E. Unmet supportive care needs and interest in services among patients with a brain tumour and their carers. Patient Educ Couns. 2008;71(2):251–8.

    PubMed  Google Scholar 

  97. Sizoo EM, Braam L, Postma TJ, Pasman HR, Heimans JJ, Klein M, et al. Symptoms and problems in the end-of-life phase of high-grade glioma patients. Neuro-Oncology. 2010;12(11):1162–6.

    PubMed  PubMed Central  Google Scholar 

  98. Anderson GD, Saneto RP. Current oral and non-oral routes of antiepileptic drug delivery. Adv Drug Deliv Rev. 2012;64(10):911–8.

    CAS  PubMed  Google Scholar 

  99. August DA, Huhmann MB, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. A.S.P.E.N Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation. Journal of Parenteral and Enteral Nutrition 2009;33(5):472–500.

    PubMed  Google Scholar 

  100. Mummudi N, Jalali R. Palliative care and quality of life in neuro-oncology. F1000Prime Rep. 2014;6:71.

    PubMed  PubMed Central  Google Scholar 

  101. Koekkoek JA, Dirven L, Reijneveld JC, Sizoo EM, Pasman HR, Postma TJ, et al. End of life care in high-grade glioma patients in three European countries: a comparative study. J Neuro-Oncol. 2014;120(2):303–10.

    CAS  Google Scholar 

  102. Janssens R, van Delden JJ, Widdershoven GA. Palliative sedation: not just normal medical practice. Ethical reflections on the Royal Dutch Medical Association’s guideline on palliative sedation. J Med Ethics. 2012;38(11):664–8.

    PubMed  Google Scholar 

  103. Walbert T. Integration of palliative care into the neuro-oncology practice: patterns in the United States. Neurooncol Pract. 2014;1(1):3–7.

    PubMed  PubMed Central  Google Scholar 

  104. Walbert T, Chasteen K. Palliative and supportive care for glioma patients. Cancer Treat Res. 2015;163:171–84.

    PubMed  Google Scholar 

  105. Walbert T, Pace A. End-of-life care in patients with primary malignant brain tumors: early is better. Neuro-Oncology. 2016;18:7–8.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neuro-Oncology, Mayo Clinic Arizona, Phoenix, AZ, USA

    Akanksha Sharma MD

  2. Department of Neurology, Alvord Brain Tumor Center, Seattle, WA, USA

    Lynne P. Taylor MD

Authors
  1. Akanksha Sharma MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lynne P. Taylor MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akanksha Sharma MD .

Editor information

Editors and Affiliations

  1. Assistant Professor, Department of Neurology, University of Washington Harborview Medical Center, Seattle, WA, USA

    Claire J. Creutzfeldt

  2. Professor of Neurology, Chief Neurology Supportive and Palliative Care Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Benzi M. Kluger

  3. Professor and Edward A. and Alma Vollertsen Rykenboer Chair, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

    Robert G. Holloway

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sharma, A., Taylor, L.P. (2019). Malignant Brain Tumors. In: Creutzfeldt, C., Kluger, B., Holloway, R. (eds) Neuropalliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-93215-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-93215-6_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-93214-9

  • Online ISBN: 978-3-319-93215-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation