title: Palliative care consultation in pediatric oncology.
abstract: OBJECTIVE
  Pediatric oncology patients benefit from the involvement of palliative care. This study examined the timing of palliative care consultation.
  
  
  METHODS
  A retrospective chart review was performed on all children from the Children's Hospital of Eastern Ontario with a diagnosis of malignancy.
  
  
  RESULTS
  Since 2006, 50 children with cancer were referred to palliative care. The mean time of referral after diagnosis was 461 days, with 8(16%) referred within 30 days of diagnosis, 13(26%) before a relapse occurred, 20(40%) after the first relapse, and 9(18%) after ≥2 relapses. Of the 40 patients referred to palliative care who died, 28% died at home, 30% in hospital, and 43% in hospice. Of the 49 oncology patients who died during the study period, 88% received a palliative care consult prior to death.
  
  
  CONCLUSIONS
  The majority of children in this study who died from cancer were referred to palliative care. Oncologists should strive to refer patients early in their disease.
authors.affiliation: Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8 L1, Canada. djohnston@cheo.on.ca
authors.forename: Donna L
authors.initials: DL
authors.lastname: Johnston
authors.forename: Christina
authors.initials: C
authors.lastname: Vadeboncoeur
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D009369:Neoplasms / Q000473:pathology / Q000628:therapy*; D009864:Ontario; D010166:Palliative Care / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors