Examen rétrospectif des dossiers : rôle des soins palliatifs dans les cas de glioblastome multiforme

Júlia Drummond de Camargo, Fernanda Avallone Machado Laureano de Souza, Ivy de Carvalho Ramalho de Oliveira, Jéssica Anastacia Silva Barbosa

Abstract


Contexte : Le glioblastome multiforme est un cancer du cerveau mortel très éprouvant pour les patients et leur famille. Il se caractérise par une progression rapide, un déclin cognitif et un faible taux de survie.

Objectif : Déterminer si les patients morts d’un glioblastome multiforme ont été suivis par l’équipe des soins palliatifs avant leur décès, si les soins invasifs ont été réduits, et si le dernier traitement antinéoplasique a été administré entre 14 et 30 jours avant le décès.

Méthode : En procédant à une étude rétrospective à partir de dossiers datés de janvier 2020 à mars 2022 tirés d’un projet mené par l’établissement hospitalier, on a recueilli les données permettant d’observer les indicateurs sélectionnés sur la qualité des soins palliatifs.

Résultat : Des 30 patients hospitalisés pour un glioblastome multiforme et décédés à l’hôpital, 50 % avaient été vus par l’équipe de soins palliatifs. Deux (6,7 %) avaient reçu un traitement antinéoplasique dans les 14 derniers jours de vie et 13 (43,3 %) avaient bénéficié d’une limitation des soins invasifs dans les deux dernières semaines de vie.

Conclusion : Pour la moitié des patients suivis par une équipe de soins palliatifs, l’arrêt du traitement antinéoplasique et la limitation des soins invasifs sont survenus au cours des 14 derniers jours de vie. Cela peut accroître la souffrance des patients et des membres de la famille, et complexifier le travail des professionnels de la santé. Il faut discuter des soins de fin de vie et de leurs objectifs avec les patients et respecter leurs choix.

Mots-clés : oncologie, soins palliatifs, glioblastome multiforme, soins de fin de vie


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