• Silvia Beretta, Daniela Polastri, Carlo Alfredo Clerici, Michela Casanova, Graziella Cefalo, Andrea Ferrari, Roberto Luksch, Maura Massimino, Cristina Meazza, Marta Giorgia Podda, Filippo Spreafico, Monica Terenziani, and Franca Fossati Bellani.
• Struttura Complessa di Oncologia Pediatrica, Istituto Nazionale Tumori, Milano, Italy. silberetta@gmail.com
• Pediatr Blood Cancer. 2010 Jan 1; 54 (1): 88-91.

BackgroundCoping with end-stage pediatric cancer patients and the related bereavement is a challenge for all the caregivers involved.ProcedureForty-seven cancer patients who died in 2006 were assessed as concerns the main place of care in the end stage of their disease, their symptoms, the palliative treatments received, and the site of death.ResultsThe end stage was managed at the Istituto Nazionale Tumori Pediatric Oncology Department in 61% of cases, at home in 26%, and in hospices or other hospital facilities in 11%. Pain was the most common symptom, followed by asthenia, anorexia, dyspnea, and nausea/vomiting. About half the patients died at home, 8.5% at our institute, 43% at other hospitals, and 8.5% in hospices.ConclusionsThe care of pediatric cancer patients during the end stage of their disease is the responsibility of the caregivers who have followed them up since their diagnosis. However, it would be useful to establish an exchange of information and expertise between pediatric oncologists and the other facilities involved (hospices, other hospitals) or people assisting patients at home (family, family pediatrician/general practitioner GP).Copyright 2009 Wiley-Liss, Inc.

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