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Pediatr Blood Cancer. 2018 Jan;65(1). doi: 10.1002/pbc.26748. Epub 2017 Aug 3.

Influence of early phase clinical trial enrollment on patterns of end-of-life care for children with advanced cancer.

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Department of Pediatric Hematology/Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.
Department of Pediatrics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.
Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.


We conducted a retrospective cohort study of 125 pediatric oncology patients who died in 2010-2014 to explore how healthcare utilization, pediatric palliative care (PPC) receipt, and end-of-life care (EOLC) differed between patients enrolled in early phase clinical trials (EP) and those not enrolled (NEP). Baseline characteristics and healthcare utilization did not significantly differ between groups. EP patients received PPC consultation closer to death than NEP patients (median days before death = 58 [interquartile range = 16-84] vs. 85 [32-173]; P = 0.04). Our findings suggest that early phase trial enrollment does not substantially alter EOLC for children with advanced cancer but may contribute to later PPC engagement. Future studies should definitively assess the relationship between trial enrollment and PPC timing.


early phase clinical trials; end-of-life care

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